Objective: Tracheal stenosis is a common complication following intubation and tracheostomy. The objective of this series was to evaluate the aetiology, perioperative management and outcome of surgery in cases of tracheal stenosis.
Methods: This series employed a retrospective analysis of patients with tracheal stenosis who underwent tracheal resection with anastomosis between January 2000 until December 2010.
Results: Ten patients, aged between 15 to 53 years old (mean of 34.4 years) were included. Post intubation injury was the major cause of tracheal stenosis (n=8), followed by external laryngeal trauma (n=2). Using the Myer Cotton classification, 60% of patients had Grade III stenosis whilst the remaining 40% had Grade IV stenosis. Pre operatively, all patients had examination under anaesthesia, with direct laryngotracheoscopy. Post-operatively, all patients were nursed in the intensive care unit for 5 days and were given intravenous antibiotics. Intravenous corticosteroids were given 24 hours before extubation. Four patients were well post operatively without complications. The most common complication in the other patients was the presence of granulation tissue in the anastomosis region (n=3), vocal cord paresis (n=2) and one restenosis (n=1). Four of these patients underwent examination under anaesthesia with removal of granulation tissue and/or laser dilatation when necessary. However, 2 cases needed Shian Lee operation and required T-tube until present. The success rate for tracheal resection and anastomosis is taken as the number of patients successfully decannulated, which in this series is 80% (n=8).
Conclusion: Tracheal resection with end-to-end anatomosis is a successful surgical procedure for cervical tracheal stenosis, with low mortality and few complications related to it. A touch up endoscopic intervention post operatively is a common but important procedure to achieve better surgical outcome.
Key words: Tracheal stenosis, laryngostenosis, acquired laryngeal stenosis.
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