Management of laryngotracheal stenosis on the basis of site and severity

Seventy-five cases of laryngotracheal stenosis treated between 1981 and 1991 were reviewed to determine the effectiveness of surgical treatment on the basis of site and severity of stenosis. Decannulation and absence of exertional dyspnea were the criteria of successful management. The treatment methods used were endoscopic laser incision and dilatation, expansion laryngotracheoplasty, and segmental resection. Endoscopic procedures were effective in treating thin (< 1 cm) stenoses in the subglottis and trachea. Laryngotracheoplasty was most effective in treating thick stenoses of the glottis and subglottis. Tracheal stenoses were most effectively treated by segmental resections. The probability for decannulation decreased with longer narrower stenoses and with increasing clinical stage.