Long-term Results and Functional Outcomes After Surgical Repair of Benign Laryngotracheal Stenosis.

Abstract

Laryngotracheal resection and anastomosis (LTRA) is a reliable treatment for benign subglottic laryngotracheal stenosis (BSLTS), but data on functional outcomes are scarce. We assessed the surgical and functional outcomes of LTRA in BSLTS. We retrospectively reviewed consecutive patients who underwent LTRA for BSLTS in 2007 to 2018. The 30-day outcomes were mortality, complications, and success rate. At the last follow-up, patients completed functional questionnaires (visual analog scale [VAS] and modified Medical Research Council scale for dyspnea, a VAS for swallowing, and the Voice Handicap Index) and assessed quality of life. Of 43 patients with BSLTS, 28 underwent the modified Pearson technique, and 15 Grillo's procedure. During the first 30 days, no patients died, the postoperative complication rate was 44%, and the success rate was 95%. After a mean follow-up of 53 months in 38 patients (88%), 7 patients had restenosis and 36 had late surgical success (95%). In the 34 patients who completed the questionnaires (79%), mean VAS dyspnea scores decreased significantly during rest (-5.4 ± 4.2) and exercise (-5.6 ± 4.4) (P < .001). A trend toward a decrease in modified Medical Research Council scale was found (P = .057; grade 0 in 62% of patients). The Voice Handicap Index indicated that voice impairment was absent to moderate in 30 patients (88%) and severe in 4 (12%). The VAS dysphagia scores were not significantly different before and after surgery. Quality of life gains were reported by 85% of patients. Laryngotracheal resection and anastomosis for BSLTS is safe and provides excellent surgical and functional outcomes with an improved quality of life. Laryngotracheal resection and anastomosis is a valid treatment option for BSLTS.