[The laryngo-tracheal reconstruction in the management of laryngo- tracheal stenosis].

Management of stenosis of the subglottic larynx remains one of the most challenging problems facing the laryngologist. This report describes our results treating severe subglottic stenosis. Five patients, 2 males and 3 females, with acquired stabilized laryngotracheal stenosis were treated during the period 1981-1991. Ages ranged from 13 to 62 years. According to Cotton's classification the patients were assigned to a grade II-IV. The cause of the stenosis was trauma in two cases and intubation injury in three. All patients had a previously placed tracheotomy. All patients underwent a Laryngo-Tracheal-Reconstruction (L.T.R.); stenting was performed with a Montgomery type silastic laryngeal T-stent. The stent remained in place between 12 and 14 months. Four patients were decannulated and obtained a satisfactory airway. In one case granulation tissue in the reconstructed subglottis required a following Laser excision. In conclusion we can underline that, in our experience and on Literature reports, L.T.R. is a safe and effective procedure for severe crico-tracheal stenosis.