[Laryngeal and laryngotracheal stenoses. Classification and treatment (author's transl)]

Results of treatment of 63 cases of laryngeal and laryngotracheal stenosis are presented and a classification of these lesions discussed. Two main types are distinguished: simple isolated stenoses (arytenoid, cricoid and tracheal) and compound stenoses (arytenocricoid, tracheocricoid, arytenotracheocricoid, arytenotracheal). Only arytenoid stenoses, those with an arytenoid component, or lesions associated with laryngeal paralysis provoke cord immobility. The arytenoid lesion therefore differentiates stenoses with fixed from those with mobile vocal cords. Treatment mainly involves adequate enlargement of the larynx and crico-tracheal resection, or a combination of these two techniques. Results were positive in 45 cases, insufficient in 5, and nil in 2 cases. Four patients were not seen again, one patient died, and 3 are still being treated. Three patients with successful results still retain a temporary tube while awaiting further therapy for another affection (esophageal stenosis). Results are analysed as a function of the site of the stenosis, the presence or absence of a tracheotomy, the technique employed, and whether previous treatment had been employed. Excluded from this report, which concerns 63 patients with laryngeal or laryngotracheal stenoses treated in the Hôpital Laennec, Paris, were cases of pure tracheal stenosis treated by resection and tracheotracheal or cricotracheal anastomosis, and with healthy cricoids, and synechiae or anterior glottic (or anterior commissural) stenoses. They were either congenital, or iatrogenic following endoscopic surgical procedures in the glottic region. Also excluded were cases of stenosis where surgery was not indicated, as well as two patients with laryngeal stenosis, one due to an amyloid tumor and the other to Launois Bensaudes disease.