The Larynxane ST intralaryngeal endoprosthesis for laryngotracheal pathologies

The authors present their experience of a new intralaryngeal silicone prosthesis used to manage laryngotracheal pathologies associated with severe deglutition and respiratory disorders.

This retrospective study, conducted in the head and neck surgery department of the Strasbourg University Hospital, France, included 10 patients (12 prostheses inserted) and was conducted from November 2000 to November 2003.

A pre-operative clinical examination and a computed tomography and/or magnetic resonance scan assessed patients' laryngeal function. Two different semirigid laryngotracheal prostheses were used, inserted under general anaesthetic into the region from the supraglottic area to the first tracheal cartilages including the vocal folds and the ventricles. In group one (n = 5), patients presented with laryngeal stenosis with preserved deglutition function, and patent prostheses were used to restore laryngeal patency. In group two (n = 5), patients suffered from severe deglutition disorders and were in poor general condition and so required a cuffed tracheostomy tube, therefore obstructed prostheses were inserted to stop aspirations and to suppress the cuff of the tracheostomy tube. The study was performed under the authorization of the Biomedical Research Patients' Protection Committee of Alsace I, France.

The mean implantation duration was six months. The prosthesis used in the first group restored laryngeal patency without further complications such as aspiration or prosthesis (mucous) obstruction. The prosthesis used in group two prevented aspiration and allowed to change a cuff by an uncuffed tracheostomy tube.

The intralaryngeal prosthesis used in group one constituted a reversible and effective method of treating laryngotracheal stenoses. The intralaryngeal prosthesis used in group two constituted an alternative to classical larynx exclusion techniques. The insertion is performed in few minutes under general anaesthetic through an endoscopic procedure. This reversible technique aimed to treat patients rapidly to reduce complications and post-operative morbidity.