Laryngotracheal resection for a post-tracheotomy stenosis in a patient with coronavirus disease 2019 (COVID-19)

Granulomatosis with polyangiitis (GPA) is an autoimmune disease characterized by necrotizing granulomatous inflammation. Subglottic stenosis, which is defined as narrowing of the airway below the vocal cords, has a frequency of 16–23% in GPA. Herein, we present the case of a 39-year-old woman with subglottic stenosis manifesting as life-threatening GPA, which was recurrent under systemic immunosuppressive therapy. The patient underwent an emergency tracheostomy, intratracheal intervention, such as carbon dioxide (CO2) laser surgery and intralesional steroid injection via laryngomicroscopic surgery, and laryngotracheal resection with remodeling. Severe subglottic stenosis treatment requires active intratracheal intervention, surgery, and systemic immunosuppressive therapy.

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Laryngotracheal resection and reconstruction for postintubation subglottic stenosis *1Lessons learned

European Journal of Cardio-Thoracic Surgery ◽

10.1016/1010-7940(93)90171-7 ◽

1993 ◽

Vol 7 (6) ◽

pp. 300-305 ◽

Cited By ~ 32

Author(s):

P MACCHIARINI ◽

A CHAPELIER ◽

B LENOT ◽

J CERRINA ◽

P DARTEVELLE

Keyword(s):

Subglottic Stenosis ◽

Laryngotracheal Resection

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Laryngotracheal resection and reconstruction for subglottic tracheal stenosis - our experience of 32 cases

Clinical Otolaryngology ◽

10.1111/coa.12347 ◽

2015 ◽

Vol 40 (2) ◽

pp. 143-147 ◽

Cited By ~ 1

Author(s):

L. Liu ◽

W. Wu ◽

Y. Ma ◽

Y. Liu ◽

Y. Wang ◽

...

Keyword(s):

Tracheal Stenosis ◽

Laryngotracheal Resection

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Laryngotracheal resection for post scleromatous laryngeal stenosis

The Journal of Laryngology & Otology ◽

10.1017/s0022215100110540 ◽

1989 ◽

Vol 103 (10) ◽

pp. 935-938 ◽

Cited By ~ 13

Author(s):

Mohamed Rifai

Keyword(s):

Residual Activity ◽

Previous Surgery ◽

Laryngeal Stenosis ◽

Endemic Disease ◽

Direct Anastomosis ◽

Laryngotracheal Resection

AbstractScleroma is an endemic disease in Egypt, which frequently results in subglottic laryngeal stenosis. Six patients suffering from laryngoscleroma are represented. They all underwent laryngotracheal resection of the stenosed segment, followed by direct anastomosis. The results were satisfactory in four of the patients. Surgery was abandoned in one patient who was believed to suffer from perichondritis following previous surgery. Restenosis occurred in a 14-year-old girl two weeks after surgery. This was attributed to recurrence, possibly due to residual activity of the disease which was missed before surgery.

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A clinical case of successful treatment of the patient after laryngotracheal resection complicated by bilateral paralysis of the larynx

Messenger of Anesthesiology and Resuscitation ◽

10.21292/2078-5658-2019-16-5-65-71 ◽

2019 ◽

Vol 16 (5) ◽

pp. 65-71

Author(s):

V. A. Zhikharev ◽

A. M. Bostanova ◽

I. S. Polyakov ◽

V. A. Koryachkin ◽

V. A. Porkhanov

Keyword(s):

Successful Treatment ◽

Clinical Case ◽

Laryngotracheal Resection

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Pregnancy-associated idiopathic laryngotracheal stenosis: presentation, management and results of surgical treatment

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezaa296 ◽

2020 ◽

Vol 59 (1) ◽

pp. 122-129

Author(s):

Luis F. Tapias ◽

Thomas J. Rogan ◽

Cameron D. Wright ◽

Douglas J. Mathisen

Keyword(s):

Risk Factors ◽

Surgical Treatment ◽

Retrospective Review ◽

Progesterone Receptors ◽

Laryngotracheal Stenosis ◽

Oestrogen Receptors ◽

Hormonal Factors ◽

Rare Association ◽

In Pregnancy ◽

Laryngotracheal Resection

Abstract OBJECTIVES Idiopathic laryngotracheal stenosis (ILTS) is an uncommon problem arising mostly in women. In some, it arises during or is exacerbated by pregnancy. Experience with management of patients with this rare association is limited. This study seeks to evaluate the management of patients with pregnancy-associated ILTS and compare outcomes to cases not associated with pregnancy. METHODS Retrospective review of 15 patients undergoing surgical treatment of pregnancy-associated ILTS from 1971 to 2013. Variables of interest and airway outcomes were compared to patients with non-pregnancy-associated ILTS. RESULTS Pregnancy-associated ILTS was observed in 15/263 (5.7%) patients. Symptoms developed during their first pregnancy. When compared to non-pregnancy patients, these patients were younger (37 vs 47 years; P = 0.0003), had more prior tracheostomies (26.7% vs 10.9%; P = 0.085) and had more preoperative airway dilatations (86.7% vs 57.7%; P = 0.030). All patients completed pregnancy without complications and ultimately underwent laryngotracheal resection. The expression of hormonal receptors in the surgical specimens was similar in both groups (oestrogen receptors: 100% vs 75% and progesterone receptors: 71.4% vs 72.1%, in pregnancy and non-pregnancy patients, respectively). Airway outcomes were good/excellent in 13 (86.7%) patients with pregnancy-associated ILTS and 225 (90.7%) patients without pregnancy association (P = 0.642), and did not change when adjusting for other risk factors. CONCLUSIONS Pregnancy-associated ILTS is rare. The pathophysiology is unclear, but appearance of symptoms during pregnancy may suggest hormonal factors. To minimize foetal risk, dilatation during pregnancy followed by laryngotracheal resection after delivery is the preferred treatment. Pregnancy association does not seem to affect outcomes with expected satisfactory results in most patients.

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