Bagheri R, Majidi Mr, Khadivi E,
Volume 67, Issue 7 (10-2009)
Abstract
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Background: Post-intubation tracheal stenosis is a
serious problem and surgical resection is the method of choice in long segment
tracheal stenosis treatment. The aim of
this study was to review the results of surgical treatment of long segment post
intubation tracheal stenosis and the role of bilateral hyoid bone cutting in
supra- hyoid release technique.
Methods: Between 2004 to 2008, 14 patients with
proximal long segment tracheal stenosis with resection of more than 40% of trachea length were
evaluated regarding surgical technique and post-operative results.
Results: The mean age of patients was 22.2±0.4 years. Etiology in
all patients were head trauma and prolonged intubation and all patients had
tracheostomy at the time of trearment. Average time between surgery and first
admission was 4.5±0.5 months. Average
length of stenosis and resected segment were 3.6±0.5 and 4.3±0.5cm respectively. Average increased length of
trachea after bilateral hyoid bone cutting was 1.1±0.3cm. Postoperative
complications occurred in one patient with wound infection, and 4 patients had
stenosis recurrence which was treated in 3 patients using multiple dilation. Quality of
life 2 years after surgery
in 71% of patients were classified
in good and excellent group. We didn't have any mortality.
Conclusion: Based on the fact that
surgery is the best method of treatment in long and multi segment tracheal
stenosis and tension in suture line is a serious problem, we recommend extended
releasing technique including bilateral hyoid cutting in surgical treatment of
these patients.