Clinical Analysis Of Surgical Treatment Of Laryngotracheal Stenosis

ObjectiveTo study the different surgical methods of laryngotracheal stenosis,to analyze the effect of the operation,to sum up the experiences and lessons,and to standardize the clinical treatment plan.MethodsA retrospective analysis of 2010 Shandong province Qianfo Hill hospital-2016 16 cases of surgery patients with laryngotracheal stenosis patients,the etiology,clinical manifestations,imaging findings,endoscopic findings,pathological diagnosis,complications and typical cases,take the surgical method to different patients,and analyzed.The laryngeal papilloma(1/16),intubation granuloma(1/16),postoperative laryngeal cancer(1/16)and laryngeal tracheal laceration(3/16)patients underwent resection of the support laryngoscope under CO2 laser;squamous cell carcinoma of trachea of postoperative laryngeal cancer(1/16),pleomorphic adenoma(1/16)and tracheal adenoid cystic carcinoma(1/16)patients were underwent endoscopic tracheal tumor resection;long time endotracheal intubation anesthesia induced by laryngotracheal stenosis(1/16)and(1/16)in patients with tracheal cystadenocarcinoma,underwent sleeve resection of trachea anastomosis;subglottic carcinoma(1/16)and thyroid carcinoma(1/16)and after contusion and laceration of trachea stenosis(1/16)patients underwent laryngotracheal reconstruction(Laryngotracheal reconstruction LTR);thyroid carcinoma(1/16)induced by tracheal stenosis in old female patients,underwent nitinol stent implantation.ResultsIn this study,16 patients were followed up for a period of 1 to 3 years.Among them,16 cases of patients,the cure rate of 10 cases,all extubation,breathing,swallowing and phonation function improved,relieve cough;two surgery 3 patients,including 2 cases with laryngeal stenosis were treated with CO2 laser resection of scar formation,clinical scar again give CO2 laser,plugging in 72 for hours after extubation,the other 1 cases of patients with laryngotracheal reconstruction,implantation of T type silicone rubber tube,pipe plugging after 72 hours of extubation;the overall success rate of operation was 81.2%(14/16).Before extubation in 3 cases,including 1 cases with laryngeal reconstruction and T tube implantation after upper granulation,sputum blockage removed,placed tracheal cannula is not blocking tube,the failure of the operation;1 cases of squamous cell carcinoma for subglottic laryngotracheal reconstruction placed T tube after granulation growth again,consider the repair of skin flap collapse;1 cases of CO2 patients with trauma after laser surgery dyspnea eased,but self-reported plugging have shortness of breath,dyspnea,consider the patients used the tracheal tube assisted breathing,even laryngostenosis significantly improved than before still hold your breath,be with tube for a long time without breathing and extubation;3 cases were unable to extubation long,tube.The first 3 cases were discharged automatically after discharge,and the last 1 cases were followed up.ConclusionsThe larynx and cervical trachea mucosa wounds after scar granulation,tumor formation is mainly caused by laryngotracheal stenosis etiology,clinical treatment,according to the location and severity of stenosis,different surgical methods can obtain good results.