[Treatment of stenoses of the laryngotracheal junction and the cervical trachea].

In the past 20 years we have operated on 187 patients for tracheal stenoses. Dilatation, tracheopexy with ring support, sleeve resection, and the gutter procedure are described. In recent years we have replaced open treatment of the tracheal gutter with our closed method. After expanding the posterior wall, the anterior tracheal wall is closed with a myocutaneous island flap, rib cartilage or a myomucosal flap. The merits of the different methods are discussed. Dilatation of the trachea and reconstruction of the anterior tracheal wall over a silicone tube in a one stage procedure creates a sturdy trachea, which is better able to resist scar contracture and pressure from the soft parts of the neck than an open U-shaped gutter. The number of operations and days of treatment per patient are materially reduced by the closed method.