Challenging tracheal resection anastomosis: Case series

Challenging tracheal resection anastomosis: Case series:



Publication date: Available online 5 February 2020

Source: Auris Nasus Larynx

Author(s): Hisham Atef Ebada, Ahmed Musaad Abd El-Fattah, Eman Hamdy Salem, Mohammed Yahia Elkotb, Elsharawy Kamal, Ali Tawfik

Abstract

Objectives

This study was conducted to review our experience in Otorhinolaryngology Department, Mansoura University Hospitals, Egypt, in the last 2 years in the management of high-risk patients who underwent cricotracheal resection due to different pathologies.

Methods

This case series included nine patients with severe, grade III or IV subglottic / cervical tracheal stenosis. These patients were considered high risk patients due to unusual pathology / etiology of stenosis or associated surgical field morbidity. Four patients had recurrent stenosis after previous unsuccessful cricotracheal resection, three patients had subglottic stenosis due to external neck trauma which compromised the surgical field. One patient had upper tracheal neoplasm, and in 1 patient there was upper tracheal stenosis associated with tracheo-esophageal fistula.

Results

Successful decannulation was achieved in all patients (n = 9) without any reported major intraoperative or postoperative compilations.

Conclusion

Cases of subglottic / upper tracheal stenosis due to uncommon pathologies like neoplastic lesions, external neck trauma compromising the surgical field and revision cricotracheal resection, can be successfully managed by cricotracheal resection. However, a highly skilled team, well familiar with these surgeries, is mandatory to achieve an optimum outcome.