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End-to-end anastomosis in the management of laryngotracheal defects

  • E D Gozen (a1), M Yener (a1), Z B Erdur (a1) and E Karaman (a1)
Abstract Objective:

To present clinical experience and surgical outcomes of end-to-end anastomosis in the management of laryngotracheal stenosis and tracheal defects following invasive thyroid malignancy resection.


A retrospective analysis was performed of 14 patients with laryngotracheal stenosis and tracheal invasive thyroid malignancy. All patients underwent tracheal or cricotracheal resection and primary end-to-end anastomosis.


Length of stenosis was 1.7–4 cm. Stenosis was classified as Myer and Cotton grade II in 4 patients, grade III in 6 and grade IV in 2. Surgical procedures included tracheotracheal end-to-end anastomosis (n = 4), cricotracheal anastomosis (n = 2) and thyrotracheal anastomosis (n = 6). Patients with invasive thyroid malignancy underwent segmental resection of the involved segment with tumour-free margins, and tracheal or cricotracheal end-to-end anastomosis. Successful decannulation was achieved in 13 patients (93 per cent). Post-operative complications were: wound infection (n = 1), subcutaneous emphysema (n = 1), temporary unilateral vocal fold palsy (n = 1), granulation tissue development (n = 1), and restenosis (n = 2).


End-to-end anastomosis can be used safely and successfully in the management of advanced laryngotracheal stenosis and wide laryngotracheal defects. Greater success can be achieved using previously described surgical rules and laryngotracheal release manoeuvres.

Corresponding author
Address for correspondence: Dr Emin Karaman, İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, KBB ABD, Cerrahpasa, Fatih, 34098, İstanbul, Turkey E-mail:
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2 JL Stauffer , DE Olson , TL. Petty Complications and consequences of endotracheal intubation and tracheostomy: a prospective study in 150 critically ill adult patients. Am J Med 1981;70:6576

3 FG Pearson , MJ. Andrews Detection and management of tracheal stenosis following cuffed tube tracheostomy. Ann Thorac Surg 1971;12:359–74

4 HC Grillo , DM Donahue , DJ Mathisen , JC Wain , CD. Wright Postintubation tracheal stenosis: treatment and results. J Thorac Cardiovasc Surg 1995;109:486–92

5 CM Myer , DM O'Connor , RT. Cotton Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol 1994;103:319–23

7 HC. Grillo Primary reconstruction of airway after resection of subglottic laryngeal and upper tracheal stenosis. Ann Thorac Surg 1982;33:318

8 R Wynn , G Har-El , JW. Lim Tracheal resection with end-to-end anastomosis for benign tracheal stenosis. Ann Otol Rhinol Laryngol 2004;113:613–17

10 L Liu , W Wu , Y Ma , Y Liu , Y Wang , EK Oghagbon Laryngotracheal resection and reconstruction for subglottic tracheal stenosis--our experience of 32 cases. Clin Otolaryngol 2015;40:143–7

11 S Pookamala , R Kumar , A Thakar , C Venkata Karthikeyan , AS Bhalla , RC. Deka Laryngotracheal stenosis: clinical profile, surgical management and outcome. Indian J Otolaryngol Head Neck Surg 2014;66:198202

13 N Zias , A Chroneou , MK Tabba , AV Gonzalez , AW Gray , CR Lamb Post tracheostomy and post intubation tracheal stenosis: report of 31 cases and review of the literature. BMC Pulm Med 2008;8:18

14 DA Sharpe , K Dixon , K. Moghissi Endoscopic laser treatment for tracheal obstruction. Eur J Cardiothorac Surg 1996;10:722–6

15 P Marques , L Leal , J Spratley , E Cardoso , M. Santos Tracheal resection with primary anastomosis: 10 years experience. Am J Otolaryngol 2009;30:415–18

16 R Rubikas , I Matukaitytė , JJ Jelisiejevas , M. Račkauskas Surgical treatment of non-malignant laryngotracheal stenosis. Eur Arch Otorhinolaryngol 2014;271:2481–7

17 T Krajc , M Janik , R Benej , M Lucenic , I Majer , J Demian Urgent segmental resection as the primary strategy in management of benign tracheal stenosis. A single center experience in 164 consecutive cases. Interact Cardiovasc Thorac Surg 2009;9:983–9

18 FS Rosen , AM Pou , WL. Buford Tracheal resection with primary anastomosis in cadavers: the effects of releasing maneuvers and length of tracheal resection on tension. Ann Otol Rhinol Laryngol 2003;112:869–76

20 WW. Montgomery Suprahyoid release for tracheal anastomosis. Arch Otolaryngol 1974;99:255–60

21 HH Dedo , NH. Fishman Laryngeal release and sleeve resection for tracheal stenosis. Ann Otol Rhinol Laryngol 1969;78:285–96

23 M George , F Lang , P Pashe , P. Monier Surgical management of laryngotracheal stenosis in adults. Eur Arch Otorhinolaryngol 2005;262:609–15

24 H Negm , M Mosleh , H. Fathy Circumferential tracheal resection with primary anastomosis for post-intubation tracheal stenosis: study of 24 cases. Eur Arch Otorhinolaryngol 2013;270:2709–17

25 L Couraud , JB Jougon , JF. Velly Surgical treatment of nontumoral stenoses of the upper airway. Ann Thorac Surg 1995;60:250–6

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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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