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Tracheal resection anastomosis in neurologically compromised patients: no longer a contra-indication, with promising outcomes

Published online by Cambridge University Press:  26 December 2025

Ahmed Musaad Abd El-Fattah ,
Eman Hamdy Salem ,
Fedaey Ramadan Habaza ,
Mohamed Arafa Shady ,
Tamer Abou-Elsaad  and
Hisham Atef Ebada Open the ORCID record for Hisham Atef Ebada [Opens in a new window]
Ahmed Musaad Abd El-Fattah
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Eman Hamdy Salem
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Fedaey Ramadan Habaza
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Mohamed Arafa Shady
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Tamer Abou-Elsaad
Affiliation:
Phoniatric Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Hisham Atef Ebada*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
*
Corresponding author: Hisham Atef Ebada; Email: hishamebada@mans.edu.eg
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Abstract

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.

Keywords

tracheatracheal stenosisco-morbidityneurologytracheostomy

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 140 , Issue 4 , April 2026 , pp. 459 - 464
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

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Footnotes

Hisham Atef Ebada takes responsibility for the integrity of the content of the paper

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