RESUMEN
The objective of the present study was to estimate the long-term results of the closure of large laryngeal and tracheal stomas with the use of the polypropylene mesh. The study included 33 adult patients presenting with extensive laryngeal and tracheal stomas. A total of 34 surgical interventions were performed for alloplastic correction of these defects. The complete closure of the tracheal and laryngeal defects with the incorporation of the prosthesis and restoration of respiration was achieved in 88.2% of the alloplastic procedures. The long-term follow-up of the treated patients (median: 75 months) failed to reveal any signs of mesh rejection. Moreover, none of the patients reported an appreciable feeling of discomfort at the site of mesh localization. Thus, the results of the study indicate that the alloplastic correction of laryngeal and tracheal stomas with the implantation of the modern mesh prostheses from polypropylene monofilaments provides the safe and reliable alternative to autoplastic surgery. Low rigidity of the modern prosthetic meshes ensures good immediate results of implant survival in the absence of long-term complications associated with the durable presence of the polypropylene mesh on the neck.
Asunto(s)
Laringoplastia , Procedimientos de Cirugía Plástica , Polipropilenos/uso terapéutico , Complicaciones Posoperatorias , Mallas Quirúrgicas , Traqueostomía/efectos adversos , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Laringoplastia/instrumentación , Laringoplastia/métodos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugía , Procedimientos de Cirugía Plástica/instrumentación , Procedimientos de Cirugía Plástica/métodos , Reoperación/instrumentación , Reoperación/métodos , Tiempo , Traqueostomía/métodos , Resultado del TratamientoRESUMEN
The objective of the present retrospective study was to evaluate the clinical experience with the use of the two-step laryngotracheoplasty for the treatment of subglottic and combined subglottic and upper tracheal cicatrical stenosis in the adult patients during the period between 2003 and 2012. A total of 13 patients were retrospectively reviewed following the surgical treatment for the management of subglottic and combined subglottic and upper tracheal cicatrical stenosis based at the Lugansk regional clinical hospital. The effectiveness of two-stage laryngotracheoplasty was estimated to be 84.6%. The number of the surgical procedures per patient depended on the extent of tracheal stenosis while the overall rehabilitation period mainly depended on the severity of the concomitant pathologies. The technical aspects and the results of the surgical treatment are discussed.
