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Adult laryngotracheal stenosis: etiology and surgical management

Lorenz, Robert R.

Current Opinion in Otolaryngology & Head & Neck Surgery: December 2003 - Volume 11 - Issue 6 - pp 467-472
Laryngology and bronchoesophagology

Purpose of review: The most common causes of laryngotracheal stenosis have changed over the last 100 years, with external trauma and infection being supplanted by iatrogenic trauma from intubation and tracheotomy. Modern-day surgeons continue to struggle with the prevention and the treatment of this difficult problem, and the purpose of this review is to examine new causes, diagnostic methods, and treatments in laryngotracheal stenosis.

Recent findings: Recent publications have focused on the topics of idiopathic subglottic stenosis; percutaneous dilational tracheotomy, with the possibility of this technique increasing the incidence of stenosis; the role of laryngopharyngeal reflux; and the use of primary resection with anastomosis as a curative treatment.

Summary: Although promising work has been reported in the treatment of laryngotracheal stenosis, notably with primary resection and anastomosis, many questions remain to be answered, especially in the causes of this potentially life-threatening disease.

Department of Otolaryngology and Communicative Disorders, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

Correspondence to Robert R. Lorenz, MD, Department of Otolaryngology and Communicative Disorders, The Cleveland Clinic Foundation, A-71 9500 Euclid Avenue, Cleveland, OH 44195, USA

Tel: 216-444-6686; fax: 216-445-9409; e-mail: robertlorenz@aya.yale.edu

© 2003 Lippincott Williams & Wilkins, Inc.