Abstract
The aim of our study is to analyze the efficacy of nasal septal cartilage as cap-graft in laryngo-tracheoplasty in cases of Laryngotracheal stenosis. This was a prospective observational study carried out at a tertiary care hospital from March 2020 to March 2023. Total 8 patients who underwent laryngo-tracheoplasty using nasal septal cartilage as anterior Cap-graft were included in the study. Detailed history and clinical evaluation followed by diagnostic Flexible Fiber-optic Laryngoscopy and radiological investigations were done for all patients with post operative follow up for at least 1 year. Our study had maximum patients in age group of 11–30 years with male predominance, unknown compound ingestion being most common cause of intubation which was followed by tracheostomy. All patients had Cotton Mayer Grade III or IV subglottic stenosis. Out of 8 patients, 5 patients are decannulated, 1 patients still have T-tube in-situ whereas 2 patients didn’t tolerate decannulation and required re-exploration. No donor site complication was seen during the study period. Nasal septal cartilage is a viable option for being used as anterior cap graft in laryngo-tracheoplasty. It can be a game changer, as can be done by E.N.T surgeon himself. No separate learning skills are required. It’s cosmetically better with minimal complications; compared to life threatening complications like pneumothorax on using costal cartilage. Laryngeal framework is preserved as opposed to thyroid alar cartilage graft. Faster healing along with better postoperative donor site recovery are significant advantages.
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References
Pookamala S et al “Laryngotracheal Stenosis: clinical profile, Surgical management and outcome.” Indian J Otolaryngol Head-Neck Surg 2014 Jan; 66 (Suppl 1): 198–202
Prasad, Kelkar et al (2004) Management of laryngo-tracheal stenosis by shiann - yann lee technique. Indian J Otolaryngol Head Neck Surg Jan(1):1–4
Grillo HC, Mathisen DJ (1988 Jun) Surgical management of tracheal strictures. Surg Clin North Am 68(3):511–524
Nikolovski N, Kopacheva-Barsova G, Pejkovska A (2019 May) Laryngotracheal stenosis: a retrospective analysis of their aetiology, diagnose and treatment. Open Access Maced J Med Sci 26(10):1649–1656
Hale Aslan S, Ozturkcan E, Eren M, Basglu (2013) Murat songu, Erkan Kulduk. Ahmet Erden Kilavuz, Huseyin Katilmus: results of Montgomery T-Tube in Primary Treatment of Laryngotracheal stenosis. Int J Otolaryngol Head Neck Surg 2:151–155
Mohammed Naveed Ahmed M, Mahendra Kumar S, Muneeruddin Ahmed G, Shahul (2014) Hameed and G. Siva Prasad A clinical study of laryngo- tracheal stenosis. Al Ameen J Med Sci 7(30):229–234
Harry H, Chhetri (2015) MD1, and Gerald S. Berke, MD. A comparative study of cricotracheal resection and staged Laryngotracheoplasty for adult subglottic stenosis. Ann Otol Rhinol Laryngol Ching, MD1, Abie H. Mendelsohn, MD1, Isabelle Y. Liu, MD1, Jennifer Long, MD, PhD1, Dinesh K. Chhetri, MD1, and Gerald S. Berke, MD. A comparative study of cricotracheal resection and staged Laryngotracheoplasty for adult subglottic stenosis. Ann Otol Rhinol Laryngol. Apr;124(4):326 – 33
Connor D, Bilish (2011Mar) David Choy and Shyan Vijayasekaran. Laryngotracheoplasty to avoid tracheostomy in neonatal and infant subglottic stenosis. Otolaryngol Head Neck Surg 144(3):435–439
Fraga JC, Schopf L, Forte V (2001 August) Thyroid alar cartilage laryngotracheal reconstruction for severe pediatric subglottic stenosis. J Pediatr Surg 36(8):1258–1261
Carolyn V, Nguyen MD, John P, Bent MD, Maulik B (2010) Shah Pediatric primary anterior laryngotracheoplasty: thyroid ala vs costal cartilage grafts. et al Arch Otolaryngol Head Neck Surg 136(2):171–174
Lava CX, Martin TS, Leonard JA, Blumenthal DL, Scriven-Weiner K, Chu E, Harley EH (2023 Feb) Complications associated with costal cartilage harvest in pediatric laryngotracheal reconstruction. Laryngoscope Investig Otolaryngol 28(2):584–590
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Chauhan, N., Gupta, R., Shah, I.A. et al. Nasal Septal Cartilage as Anterior Cap-Graft for Open Tracheoplasty in Cases for Laryngotracheal Stenosis: Our Initial Experience. Indian J Otolaryngol Head Neck Surg 75, 3671–3678 (2023). https://doi.org/10.1007/s12070-023-04065-w
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DOI: https://doi.org/10.1007/s12070-023-04065-w