[Primary thyrotracheal anastomosis for subglottic stenosis with tracheostomy]

Area of Science:

• Otolaryngology
• Thoracic Surgery
• Surgical Pathology

Background:

• Subglottic stenosis is a narrowing of the airway below the vocal cords, often resulting from prolonged intubation or prior tracheostomy.
• Thyrotracheal anastomosis is a surgical procedure to reconstruct the airway by connecting the trachea to the thyroid cartilage.

Observation:

• A 42-year-old male patient with postintubation subglottic stenosis underwent thyrotracheal anastomosis.
• A prior longitudinal tracheostomy incision complicated the surgery, necessitating a longer tracheal resection and anastomosis to the thyroid cartilage.
• Postoperatively, the patient experienced tracheal collapse at the site of the longitudinal incision.

Findings:

• Tracheal patency was successfully restored one week after intubation.
• The longitudinal tracheostomy incision contributed to the complexity and length of the required tracheal resection.
• The case demonstrated a risk of tracheal collapse associated with longitudinal tracheostomy incisions in subglottic stenosis reconstruction.

Implications:

• A horizontal tracheostomy incision is recommended for patients with subglottic stenosis undergoing similar surgical approaches.
• This recommendation aims to mitigate the risk of tracheal collapse and improve surgical outcomes.
• Optimizing tracheostomy techniques can enhance airway reconstruction success in challenging cases.