The Journal of laryngology and otology · 2026
Tracheal resection anastomosis in neurologically compromised patients: no longer a contra-indication, with promising outcomes.
СтатьяНазвание и аннотация: Перевод в очереди
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Abd El-Fattah Ahmed Musaad, Salem Eman Hamdy, Habaza Fedaey Ramadan, Shady Mohamed Arafa, Abou-Elsaad Tamer, Ebada Hisham Atef
Аннотация
OBJECTIVES: To highlight our experience in the management of patients with severe subglottic and/or upper tracheal stenosis associated with neurological co-morbidities. Effective tips and tricks in the surgical technique were emphasised.
METHODS: This study included 33 patients with neurological co-morbidities who underwent tracheal and/or cricotracheal resection anastomosis. To decrease the anastomotic tension, suprahyoid release was performed and trachea-hyoid detensioning stitches were placed. Surgiflo® was applied over the anastomosis to enhance healing. Surgical and functional outcomes were evaluated.
RESULTS: The decannulation rate was 90.9 per cent. Regarding the functional outcomes, significant improvement of voice and swallowing was noticed after surgery. None of the patients experienced deterioration in their pre-existing neurological conditions following surgery.
CONCLUSION: Patients with severe subglottic and/or upper tracheal stenosis associated with neurological co-morbidities are challenging. Certain refinements in the surgical technique such as tailored suprahyoid release, tracheo-hyoid detensioning stitches and the application of Surgiflo are crucial to enhance healing, decrease anastomotic tension and improve outcomes.
METHODS: This study included 33 patients with neurological co-morbidities who underwent tracheal and/or cricotracheal resection anastomosis. To decrease the anastomotic tension, suprahyoid release was performed and trachea-hyoid detensioning stitches were placed. Surgiflo® was applied over the anastomosis to enhance healing. Surgical and functional outcomes were evaluated.
RESULTS: The decannulation rate was 90.9 per cent. Regarding the functional outcomes, significant improvement of voice and swallowing was noticed after surgery. None of the patients experienced deterioration in their pre-existing neurological conditions following surgery.
CONCLUSION: Patients with severe subglottic and/or upper tracheal stenosis associated with neurological co-morbidities are challenging. Certain refinements in the surgical technique such as tailored suprahyoid release, tracheo-hyoid detensioning stitches and the application of Surgiflo are crucial to enhance healing, decrease anastomotic tension and improve outcomes.