Laryngotracheoplasty for Laryngotracheal Stenosis Post Intubation and Post Tracheostomy: A Case of Stenting with Airway Exchange Catheter View PDF

^*Deguenonvo REA
Ent Department, Hospital General De Grand-Yoff (HOGGY), Cheikh Anta Diop University, Senegal

^*Corresponding Author:

Deguenonvo REA
Ent Department, Hospital General De Grand-Yoff (HOGGY), Cheikh Anta Diop University, Senegal
Email:deguenonvorichard@yahoo.fr

Published on: 2016-04-05

Abstract

We received a 27 year-old man with past medical history of asthma and cerebral malaria managed by intubation and tracheostomy for assisted ventilation. The lung specialist for suspicion of laryngotracheal stenosis referred him. At presentation, he was complaining of noisy breathing with respiratory difficulty mistaken for asthma. Computed tomography found laryngotracheal stenosis of 19 mm long and 6 mm thick with a distored cricoid cartilage with partial erosion Flexible laryngoscopy showed normal mobility of vocal folds and a grade III subglottic stenosis. Emergency tracheostomy was performed for moderate to severe dyspnea. Posterior cricoid split with costal cartilage augmentation and stenting was performed. Because Montgomery T-tubes were not available, we used a fashioned airway exchange catheter as a stent. Post recoveries were marked by infection and mucus plugging in tracheal cannula. Stent removal was done 2 months later with decannulation the same day. Follow-up was achieved for 18 months without re-stenosis

Keywords

Laryngotracheal stenosis; Laryngotracheoplasty; Cricoid cartilage; Prolonged intubation; Tracheostomy; Stent; Airway exchange catheter

Introduction

Laryngotracheal stenosis is defined as a partial or complete cicatricial narrowing of the endolarynx or trachea. The complexity of the region which contains delicate structures such as vocal cords, recurrent laryngeal nerve which coordinate the functions of respiration, deglutition and phonation make of the laryngotracheal stenosis, a difficult entity to manage. Laryngotracheal stenosis is most frequently secondary to prolonged intubation/tracheostomy with assisted ventilation.