TRACHEAL RESECTION FOR A POST-TRACHEOSTOMY STENOSIS

Tracheal stenosis is a rare but severe complication after longtime intubation and tracheostomy. It is the result of an abnormal healing process with uncontrolled scarring leading to a gradual narrowing of the airway. Patients become symptomatic months to years after decanulation with increasing exertion dyspnea and progressive stridor. Interventional techniques like dilation, laser resections or stent placements only relief symptoms for a short time usually leading to a more severe restenosis thereafter. The only long-term success can be achieved by surgical correction and removal of the affected tracheal segment. Herein, we report two typical cases of post-tracheostomy stenosis treated in our institution. In both patients the diseased parts of the trachea were removed and an end-to-end anastomosis was performed. Functional results were optimal and control endoscopies revealed a well-healed anastomosis. 2 years and 6 months after the procedures both patients are well without any symptoms. A surgical correction of the tracheal stenosis is the treatment of choice in post-tracheostomy stenosis patients. The procedure is safe and leads to good results in experienced hands. For an optimal outcome patients should be referred to an interdisciplinary competence center of laryngotracheal surgery.