Treatment of Laryngotracheal Stenosis with Cricoid Cartilage Necrosis

Two patients with inflammatory stenosis of the subglottic larynx and upper trachea due to high tracheostomies underwent an open treated reconstruction. Stenosis was observed at the level of the cricoid cartilage in one case, and at the cricoid cartilage and upper trachea in the other case. In both cases, a partial defect of the cricoid cartilage was observed on a preoperative CT scan of the larynx.Both patients were successfully treated using the “trough” method. In the initial stage, we created a trough after resection of the stenotic region through the laryngotracheal fissure. A stent formed from a silicon dental impression was inserted into the trough to maintain the wide patency of the laryngotracheal lumen. The trough was closed with a hinge flap internally and with an advancement rotation flap externally in one of the patients six months after the initial operation. In the other patient, the trough was closed with a sternohyoid myocutaneous flap internally and given an advancement flap externally four months after the initial operation.