Two-stage repair of extensive subglottic tracheal stenosis.

The authors describe an open technique that has been used over the past 25 years to reconstruct the subglottic tracheal region in two stages after extensive laryngotracheal stenosis. After submucosal resection of fibrous tissue and reconstruction of the subglottic and tracheal skeleton by means of two autologous osseous grafts, a large laryngotracheostomy is created during the initial stage. Some weeks later, in the second stage, the anterior wall is closed, using two cervical hinge-door flaps. Ten patients have undergone this procedure, with a minimum follow-up of 3 years. All of the patients were decannulated upon completion of the treatment without recurrence of stenosis during the follow-up period.