Abstract
An analysis of 59 cases of tracheal stenosis after tracheostomy with cuffed tube and assisted ventilation is reported. Special emphasis is placed upon diagnosis and treatment. The detection of severe strictures is usually easily achieved, but mild to moderate degrees of stenosis may present difficulties in diagnosis and may remain undetected for some time.
Management of the strictures included dilatation (14 cases), segmental tracheal resection with primary end-to-end anastomosis (34 cases), staged plastic reconstruction (2 cases), and permanent tracheostomy (4 cases). No treatment was given in 5 cases.
Dilatation achieved a good result in 6 cases and a satisfactory one in 8. Of 34 strictures treated by segmental resection, a good result was obtained in 29 cases, although 7 required a second operation for restenosis. Three cases had an unsatisfactory result and there were 2 operative deaths. Postoperative complications are discussed.
Mild strictures may be satisfactorily managed by dilatation, but some mild strictures and all severe strictures are best treated by segmental resection with primary end-to-end anastomosis. Segmental defects ranging from 0.5 to 5.5 cm. in length can be satisfactorily resected.