[Plastic surgery in cicatricial laryngo-tracheal stenosis]

One hundred and thirty-seven cases of cicatricial laryngotracheal stenosis have been treated within the past 10 years. Our cases were classified into 4 types according to the destruction of the cartilagenous frame and stenosis of the airway, they were: obstructive (or blocking), collapsed, centripetally constricted and obliterative. Operative designs included recanalization, repairing, enlargement and reconstruction of the airway. With appropriate treatment of the scar and residual tissues, the airway was then supported with a silicone T-tube. Except 1 case (0.7%), 132 cases (96.4%) were detubated after an average period of one year, 4 cases (2.9%) were still under treatment. Ninety-six cases had been followed up for 2-10 years, 93 (96.9%) of them were still satisfactory. It has been stressed that the local scar tissue should be utilized to repair the wall of the larynx or trachea; the residual mucosa should be utilized to cover the denuded area in order to promoter regeneration of the ciliated epithelium; and the pediatric patients should be treated early. The silicone T-tube seems to be an ideal support for remoulding the airway. It could be placed in position for a considerable long period so as to ensure the patency of the airway.