Does Fibula Free Flap Harvesting Affect Donor Site of Patients in Facial Reconstructions: A Gait Analysis Study.

BACKGROUND: Vascularized fibula free flap (VFFF) remains gold standard for reconstruction of bony defects of the maxilla or mandible. Research and publications in recent years essentially focused on the evolution and improvement of the recipient reconstructed area but very few concerning the donor site morbidity. PURPOSE: The aim of this study was to analyze walking ability of patients following VFFF operation and to determine if there are long term walking disabilities. STUDY DESIGN, SETTING, SAMPLE: The retrospective cohort study involved healthy controls and patients who had undergone VFFF between 2012 and 2019 at the oral and maxillo-facial department of the University Hospital in Lausanne, Switzerland. Patients with cardiovascular, pulmonary, neuromuscular or musculoskeletal pathologies that could impair walking were excluded from the study. PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE: Primary predictor is the reconstruction status, VFFF versus healthy patients (controls). MAIN OUTCOME VARIABLES: Main outcomes were gait parameters. Objective evaluation of walking abilities was assessed using the Gait Up system (Gait Up SA, EPFL Innov'Park-C, Lausanne, Switzerland), which are wearable motion sensors that provides 3D analytics of the gait. COVARIATES: Covariates implied patient characteristics such as age, sex, time after surgery and subjective evaluation of the gait obtained with two orthopedic validated questionnaires. RESULTS: This study implied 10 healthy controls and 11 patients who had undergone VFFF. Results showed statistically significant differences in the speed [m/s] (1.3 vs 1.1 for a P value of .001), the stride length [m] (1.4 vs 1.2 for a P value of 0.003), the flat foot phase [%] (55.0 vs 63.3 for a P value of .006) and the pushing phase [%] (34.1 vs 25.1 for a P value of .008). CONCLUSION AND RELEVANCE: Reconstruction using vascularized autograft in maxillofacial surgery is substantial and well described. Our attention focusing on donor site morbidity has demonstrated subjective and objective long-term alterations. These results will have to be confirmed with gait analysis in a prospective project including preoperative and postoperative analysis of the gait of the patient acting himself as his own control, with a larger scale of patients.

[ORL. Drug induced sleep endoscopy (DISE): indications and benefits]. / ORL. Endoscopie du sommeil induit par les médicaments (DISE): indications et bénéfices.

Obstructive sleep apnea (OSA) is a common condition that can cause daytime or nocturnal symptoms with long-term impact on the patient's health. Various therapies and surgeries have been introduced over the years, and patient wishes and compliance are essential factors in the success of treatment. Drug-induced sleep endoscopy (DISE) is a procedure that assesses the opening and closing of the upper airway in real time. This article summarizes the indications and contraindications of DISE, with a review of sedation methods and the VOTE classification system, in order to facilitate the use of a common nomenclature based on a protocol applied at the CHUV.

Le syndrome d'apnées obstructives du sommeil (SAOS) est une affection courante pouvant provoquer des symptômes diurnes ou nocturnes ayant un impact à long terme sur la santé du patient. Diverses thérapies et chirurgies ont été introduites au fil des années et les souhaits des patients et l'observance thérapeutique sont des facteurs essentiels dans le succès du traitement. L'endoscopie du sommeil induit par les médicaments (DISE: drug-induced sleep endoscopy) permet d'évaluer l'ouverture et la fermeture des voies respiratoires supérieures en temps réel. Cet article résume les indications et contre-indications de la DISE avec un rappel des méthodes de sédation et le système de classification VOTE, afin de faciliter l'utilisation d'une nomenclature commune basée sur un protocole appliqué au CHUV.

Oropharyngolaryngeal manifestations in severe toxic epidermal necrolysis: a single-center's retrospective case series.

BACKGROUND: Toxic epidermal necrolysis is a rare and life-threatening mucocutaneous disease. Although mucosal ear, nose, and throat (ENT) involvement is common, little is known about the characteristics, treatment modalities, and outcomes of these lesions. The aim of this study was to evaluate ENT mucosal lesions in severe toxic epidermal necrolysis patients and analyze their characteristics, treatment modalities, and outcomes, as well as proposing a management algorithm to prevent long-term debilitating sequalae of these lesions. METHODS: This is a retrospective review of toxic epidermal necrolysis cases treated at the tertiary burns unit of the Lausanne University Hospital CHUV, Switzerland, between 2006 and 2019. RESULTS: Out of 19 patients with severe toxic epidermal necrolysis, 17 (89%) underwent a complete ENT examination at admission and 14 (82%) had ENT mucosal involvement. Five (26.3%) patients died during the stay in the intensive care unit. Of the 16 patients who received maximal care, 13 (81%) required orotracheal intubation for a median time of 16 (IQR: 14) days. Out of the 14 patients who survived, four (29%) had long-term ENT complications consisting of synechiaes necessitating subsequent endoscopic procedures. Those four patients all required mechanical ventilation with an orotracheal tube and suffered from hypopharyngeal synechiaes as well as oral and endonasal synechiaes in individual cases. CONCLUSION: This study suggests a high prevalence of ENT synechiaes in patients with severe toxic epidermal necrolysis and requiring orotracheal intubation. Periodic ENT examination could prevent mature synechiae formation in these patients. We propose an algorithm to prevent long-term sequalae in ENT mucosal involvement.

Preoperative CT-Based Skeletal Muscle Mass Depletion and Outcomes after Total Laryngectomy.

PURPOSE: To assess the role of preoperative CT-based skeletal muscle mass depletion on postoperative clinical outcomes and survival in patients who underwent total laryngectomy for cancer. METHODS: Patients operated on between January 2011 and March 2020 were retrospectively included. Skeletal muscle area and intra- and inter-muscular fat accumulation were measured at the third lumbar vertebral level on preoperative CT scans. Skeletal muscle mass depletion was defined based on pre-established cut-off values. Their association with postoperative morbidity, length of stay (LOS), costs, and survival was assessed. RESULTS: A total of 84 patients were included, of which 37 (44%) had preoperative skeletal muscle mass depletion. The rate of postoperative fistula (23% vs. 35%, p = 0.348), cutaneous cervical dehiscence (17% vs. 11%, p = 0.629), superficial incisional surgical site infections (SSI) (12% vs. 10%, p = 1.000), and unplanned reoperation (38% vs. 37%, p = 1.000) were comparable between the two patient groups. No difference in median LOS was observed (41 vs. 33 days, p = 0.295), nor in treatment costs (119,976 vs. 109,402 CHF, p = 0.585). The median overall survival was comparable between the two groups (3.43 vs. 4.95 years, p = 0.09). CONCLUSIONS: Skeletal muscle mass depletion alone had no significant impact on postoperative clinical outcomes or survival.

[Otorhinolaryngology - New alternative treatments for obstructive sleep apnea at the CHUV: unilateral or bilateral hypoglossal nerve stimulation]. / ORL - Nouvelles thérapies alternatives des apnées du sommeil au CHUV : stimulation du nerf hypoglosse.

Hypoglossal nerve stimulation is an alternative treatment for obstructive sleep apnea syndrome (OSAS) in patients intolerant to CPAP. The INSPIRE system (unilateral hypoglossal nerve stimulation) available since 2014 and the NYXOAH system (bilateral hypoglossal nerve stimulation) available since 2019 help to treat OSAS via activation of the genioglossus muscle causing protrusion of the tongue during sleep. We present in this article the two types of hypoglossal nerve stimulators through a recent review of the literature.

La stimulation du nerf hypoglosse est un traitement alternatif du syndrome d'apnées obstructives du sommeil (SAOS) chez des patients intolérants à la CPAP (Continuous Positive Airway Pressure). Le système INSPIRE (stimulation unilatérale du nerf hypoglosse) disponible depuis 2014, et le système NYXOAH (stimulation bilatérale du nerf hypoglosse), disponible depuis 2019, permettent de traiter le SAOS via une activation du muscle génioglosse, provoquant une protrusion de la langue pendant le sommeil. Nous présentons dans cet article les 2 types de stimulateur du nerf hypoglosse à travers une revue récente de la littérature.

Utility of flexible interventional endoscopy in endoscopic sinus surgery: a case series.

PURPOSE: During endoscopic sinus surgery (ESS), difficult-to-reach pathologies need an extended endoscopic approach or an external approach. We started to use a flexible interventional endoscope (FIE) to evaluate the necessity of those approaches. The study's objective is to describe our experience and define patients who could benefit from this technique. METHODS: We reviewed every patient who benefited from FIE associated with ESS at our tertiary University Hospital between January 2021 and February 2022. RESULTS: During this period, we did 107 ESS, and 14 patients benefited from the FIE, representing 13% of our ESS. The median duration of the flexible endoscopy time was 14 min (4-38 min). We identified three groups of patients who can benefit from the FIE. The first one is for patients with a fungal infection, to control and to clean lateral recesses in a noninvasive manner. The second one is for patients with a pathology of the lateral frontal sinus, to remove the frontoethmoidal cells or mucocele with the biopsy forceps through the working channel. The third group is for patients with inverted papillomas, to precisely identify the insertion and to decide on the most appropriate surgical approach. CONCLUSIONS: In selected cases, using flexible endoscopy during ESS helps decide the optimal surgical approach and sometimes treat the pathology through a limited approach. Prospective studies for each group of patients are needed to confirm the benefit of this new combined procedure.

[Tonsillar asymmetry in adults: review of the literature and management algorithm]. / Asymétrie amygdalienne chez l'adulte: revue de littérature et proposition de prise en charge.

Tonsillar asymmetry is both a common clinical finding and a potential sign of cancer. The diagnosis of the latter requires tonsillectomy, which is associated with two weeks off work and post-operative risk of bleeding, which ranges between 1.5 and 15% of the cases. Thus, it is crucial to determine which patients can be followed clinically and which ones will need a diagnostic tonsillectomy. This article provides a review of the literature on tonsillar asymmetry in the adult population and an algorithm for its management.

L'asymétrie amygdalienne est à la fois une découverte clinique fréquente et un potentiel signe de cancer. Le diagnostic de ce dernier se pose par une amygdalectomie. Celle-ci est associée à un arrêt de travail d'environ deux semaines, ainsi qu'à des risques postopératoires de saignement qui varient de 1,5 à 15% des cas. Il est donc crucial de déterminer quels patients peuvent être suivis cliniquement et quels sont ceux qui doivent bénéficier d'une amygdalectomie diagnostique. Cet article propose une revue de la littérature sur l'asymétrie amygdalienne dans la population adulte ainsi qu'un algorithme de prise en charge.

Second primary squamous cell carcinomas treated with trans oral robotic surgery: Oncological and functional results.

Background: Recovery of swallowing in patients treated with trans-oral robotic surgery (TORS) is in general considered as favorable. However, patients afflicted with a secondary primary carcinoma of the head and neck may be more vulnerable to swallowing dysfunctions after trans-oral surgery as a consequence of previous treatments. Methods: This is a retrospective monocentric study on patients undergoing TORS for second primary squamous cell carcinoma between 2013 and 2017 (follow-up until June 2021). Swallowing performance was assessed via the functional outcome swallowing scale (FOSS). Also, overall survival (OS), disease-free survival (DS) and disease-specific survival (DSS) were evaluated. Results: Eighteen patients (median 62 years) underwent TORS with curative intent for T1-2 oropharyngeal and supraglottic secondary primaries. The average follow-up was of 52 months. All cases were resected R0 using TORS. 84% of patients had a post-treatment FOSS score equal or better upon last follow-up compared with pre-treatment. Only one patient required a percutaneous gastrostomy long term. DSS/DFS/OS at 5 years was 94%, 60%, and 67%, respectively. The main cause of death was metachronous pulmonary neoplasia. Conclusions: Our study demonstrates encouraging results in terms of swallowing recovery in patients undergoing TORS for selected secondary primaries of the oropharynx and supraglottic larynx. Further studies into trans-oral surgery for this condition seem therefore warranted. Level of Evidence: Case series; Level 4.

The robotic-assisted extended "Sistrunk" approach for tumors of the upper aerodigestive tract with limited transoral access: First description of oncological and functional outcomes.

We report on the first clinical experience with the robotic-assisted extended "Sistrunk" approach (RESA) for access to constrained spaces of the upper aerodigestive tract. This prospective case cohort study include six patients that underwent RESA if transoral exposure could not be achieved. Three patients received previous radiation. Patients were postoperatively followed until week 16 for perioperative complications, surgical margins, and functional outcomes. In all patients RESA allowed adequate exposure and resection with negative margins. Three patients who underwent salvage surgery experienced a minor or intermediate grade postoperative bleeding. No patient developed a pharyngocutaneous fistula. Three patients recovered their swallowing to their preoperative status and the remaining three experienced an improvement. All patients experienced complete recovery of their voice. RESA has the potential to provide a new organ preservation approach for head and neck cancer (HNC) not amenable to transoral exposure and thus warrants further prospective clinical studies.

[From tonsillitis to peritonsillar abscess]. / De l'angine simple à l'abcès périamygdalien.

Acute tonsillitis is a common disease. The tonsillar infection can be uni- or bilateral with a high rate of spontaneous recovery. In some cases, a peritonsillar cellulitis or abscess can occur, characterized by an inflammatory reaction of the peritonsillar space. The red flags consist of a gradually worsening odynodysphagia, an ipsilateral swelling of the soft palate, a trismus (infrequent in children) and in some cases a change of voice (« hot potato voice ¼). A needle puncture of the swollen soft palate is then required. If pus is found, a surgical drainage by either hot tonsillectomy or incision under local anesthesia with an appropriate antibiotic therapy must be carried out.

L'amygdalite aiguë représente un motif de consultation fréquent. Elle est caractérisée par une infection amygdalienne uni ou bilatérale de résolution spontanée dans la majorité des cas. Dans certaines situations, celle-ci se complique d'un phlegmon ou d'un abcès périamygdalien caractérisés par respectivement une réaction inflammatoire ou du pus dans l'espace périamygdalien. Les signes d'alerte sont une odynodysphagie sévère latéralisée, une tuméfaction ipsilatérale du voile du palais, un trismus (rare chez l'enfant) et une modification de la voix. L'examen complémentaire comprend une ponction de la tuméfaction du voile à la recherche de pus. En cas d'abcès avéré, un drainage chirurgical en urgence par amygdalectomie à chaud ou incision sous anesthésie locale est préconisé en plus d'une antibiothérapie adéquate.

Intubation Related Laryngeal Injuries in Pediatric Population.

Introduction: Laryngeal intubation related lesions (LIRL) in pediatric patients cause extreme morbidity in both elective and emergency settings. It has a wide range of presentations from minor laryngeal edema to a life-threatening airway obstruction. We report here our units' experience with LIRL in neonates, infants, and small children. Material and Methods: This is a retrospective monocentric cohort study between January 2013 and April 2019. Results: Thirty-nine patients with intubation lesions were included in the study. We looked at the lesions type, characteristics, management, and outcome. Half the patients were premature and having comorbidities. Main LIRL were subglottic stenosis (31%), ulcers (26%), granulations (18%), retention cysts (18%), posterior glottic stenosis (13%), and vocal cords edema (5%). Unfavorable lesions causing airway stenosis were associated with an intubation duration of over 1 week and were an important factor in causing airway stenosis (p < 0.05). The endoscopic treatment performed for these lesions was lesion and anatomical site-specific. Tracheostomy was needed in five patients, and was avoided in another two. Seven patients (18%) received open surgery prior to their decannulation. Conclusions: LIRL management is challenging and stressful in the pediatric population and optimal treatment could avoid extreme morbidity in them. Intubation duration and associated comorbidities are important factors in deciding the severity of these lesions. Protocols to prevent the formation of these lesions are critical.

[Obstructive sleep apnea syndrome : CPAP or Mandibular Advancement Device?] / Syndrome d'apnées obstructives du sommeil : CPAP ou orthèse d'avancement mandibulaire ?

Obstructive sleep apnea syndrome (OSAS) is a respiratory disorder affecting up to 49 % and 23 % of middle to older aged men and women respectively. CPAP (continuous positive airway pressure) is the gold-standard treatment for severe apneas. In mild and moderate forms of OSAS, mandibular advancement devices (MAD) are equally a first line of treatment. Both CPAP and MAD have their advantages and side effects. Patient tolerance to these two therapies varies according to different patient-parameters. In order to guide physicians and patients in choosing between these two treatments, we present a description of both treatment modalities.

Le syndrome d'apnées obstructives du sommeil (SAOS) est un trouble respiratoire du sommeil qui affecte jusqu'à 49 % des hommes et 23 % des femmes d'âge moyen à avancé. La ventilation en pression positive continue (CPAP) est actuellement le traitement de choix pour les cas sévères. Dans les stades léger et modéré de SAOS, l'orthèse d'avancement mandibulaire (OAM) est également un traitement que l'on peut proposer en première intention. La CPAP comme l'OAM ont leurs avantages et leurs inconvénients. La tolérance pour ces deux thérapies varie d'un patient à l'autre. Afin de guider le praticien et le patient dans le choix de ces deux traitements, nous proposons une description des deux modalités thérapeutiques.

[Atypical neck pain: an example of a little-known syndrome]. / Douleur au cou atypique: exemple d'un syndrome peu connu.

Eagle's syndrome is an unknown disease. Its suspicion is first and foremost clinical and his symptoms are diverse. The diagnosis is confirmed by imaging. Its management is surgical: resection of the styloid process by trans-oral or trans-amygdala route. Patients often consult several specialists and there are many investigations before the right diagnosis is made.

Le syndrome d'Eagle est un diagnostic méconnu. Sa suspicion est d'abord clinique et ses symptômes sont divers. Le diagnostic est confirmé par imagerie. Sa prise en charge est chirurgicale: résection du processus styloïde par voie transorale ou trans-amygdalienne. Les patients consultent souvent plusieurs spécialistes et les investigations sont nombreuses avant que le bon diagnostic soit posé.

A new endoscopic surgical approach to the larynx, hypopharynx, and neck lymphatics: The robotic-assisted extended "Sistrunk" approach (RESA).

BACKGROUND: We report on the feasibility of a novel robotic-assisted extended "Sistrunk" approach (RESA) to the larynx, hypopharynx, and lateral neck lymphatics. METHODS: Studies were performed using the da Vinci Xi and SP system on three cadavers comprising of three supraglottic laryngectomies, one partial hypopharyngectomy, and four lateral level II to IV neck dissections. RESULTS: In all resections at first a central common working space overlying the hyoid bone was created. The da Vinci Xi system was used with two vestibular and two submental ports for laryngeal/hypopharyngeal resections, and an additional port through a facelift incision for level II to IV neck dissections. The da Vinci SP system was used with only one submental port. CONCLUSIONS: We describe herein a novel endoscopic robotic approach to the larynx, hypopharynx, and neck based on the traditional "Sistrunk" procedure. The technique should help improving exposure of the primary lesion and reduce access-related morbidity to the neck.

Mucosal Melanoma of the Head and Neck: A Retrospective Review and Current Opinion.

Introduction: Head and Neck Mucosal Melanoma (HNMM) is an uncommon malignancy that arises in decreasing order in the nasal cavity, the paranasal sinuses, and the oral cavity. Although radical surgery followed by eventual radiotherapy is acknowledged as the mainstay treatment, patients with advanced stages or multi-focal tumors benefit from new systemic therapies. We wish to share our experience with these treatments and review the current literature. Materials and Methods: We present a case review of every patient treated in our center for an HNMM over the past 10 years, including every patient treated in our center for an HNMM over the past 10 years. We analyzed clinical characteristics, treatment modalities, and outcomes. Results: We included eight patients aged from 62 to 85 years old. We found six MM in the nasal cavity, one in the sphenoidal sinus, and one in the piriform sinus. Six patients underwent endoscopic surgery with negative margins, six underwent radiotherapy with variable modalities. Immunotherapy or targeted therapy was given in cases extensive tumors without the possibility of a surgical treatment or in two patient as an adjuvant treatment after R0 surgery. The three-year overall survival was 50%, and three patients (37.5%) are in remission. Conclusions: HNMM is associated with poor oncologic outcomes regarding the concerned patients of our review, as reported in the literature. New treatments such as immunotherapies or targeted therapies have not significantly changed the prognosis, but they may offer new interesting perspectives. Our small series of cases seems to confirm that surgical resection with negative margins improves overall survival.

[New therapy for sleep apnea at CHUV: hypoglossal nerve stimulation]. / Nouvelle thérapie de l'apnée du sommeil au CHUV: le neurostimulateur du nerf hypoglosse.

Neurostimulation of the hypoglossal nerve is a new alternative treatment to CPAP (Continuous Positive Airway Pressure) for patients with moderate-to-severe OSAS (Obstructive Sleep Apnea Syndrome) with anteroposterior pharyngeal obstruction visualized during a Drug Induced Sleep Endoscopy (DISE). Implantation and follow-up are performed at the CHUV with the collaboration between the SAOS-ronchopathie unit, the maxillofacial and dental surgery division and the center for investigation and research on sleep (CIRS). In this article, we present the technique, its indication and the outcomes through a recent review of the literature. This new device has been used for five years, mainly in the United States and Europe.

La neurostimulation du nerf hypoglosse est un nouveau traitement alternatif à la CPAP (Continuous Positive Airway Pressure: ventilation en pression positive continue) pour les patients présentant un SAOS (syndrome d'apnées obstructives du sommeil) de stade modéré à sévère avec une obstruction pharyngée antéro-postérieure, objectivée lors d'un examen endoscopique en sommeil induit (DISE). L'implantation du dispositif et le suivi sont réalisés au CHUV grâce à une étroite collaboration entre l'Unité SAOS-ronchopathie, la division de chirurgie maxillo-faciale et dentaire et le Centre d'investigation et de recherche sur le sommeil (CIRS). Dans cet article, nous présentons la technique, ses indications ainsi que les résultats à travers une revue de la littérature récente sur cette technologie qui est pratiquée depuis maintenant cinq ans, principalement aux Etats-Unis et en Europe.

Role of Unilateral Vocal Cord Palsy in Causing Recurrent Tracheobronchial Foreign Bodies.

Background: Foreign body (FB) aspiration in children is a frequent condition managed by ENT pediatric surgeons and pediatric pulmonologists. Methods: We present the case of a 20-months-old child who presented with three recurrent episodes of FB aspiration. Results: At the time of FB removal, an initial dynamic examination of the larynx revealed a unilateral vocal cord palsy (UVCP). Conclusion: For recurrent tracheobronchial FB inhalation, we recommend a systematic dynamic airway endoscopy.

[Sleep apnea : diagnostic and therapeutic modalities in case of failure of the CPAP]. / Apnées du sommeil : modalités diagnostiques et thérapeutiques en cas d'échec de la CPAP.

Obstructive sleep apnea (OSA) is a sleep disorder that affects 49 % of men and 23% of women over 40 years old. CPAP is currently the treatment of choice for severe OSAS, but there are mild to moderate cases of OSAS with poor compliance or intolerance to CPAP, for which alternative treatments should be considered. In this article, we present a tool for evaluation of the upper airways, the DISE (Drug-induced sleep endoscopy), the OAM (mandibular advancement device), the bimaxillary advancement osteotomy, the hypoglossal nerve stimulation and the positional treatment.

Le syndrome d'apnées obstructives du sommeil (SAOS) est un trouble du sommeil qui affecte 49 % des hommes et 23 % des femmes de plus de 40 ans. La CPAP est actuellement le traitement de choix pour les SAOS sévères, mais il existe des cas de SAOS de degré léger à modéré qui présentent une mauvaise compliance, voire une intolérance à la CPAP, pour lesquels il faut envisager des traitements alternatifs. Dans cet article, nous vous présentons un outil d'évaluation des voies aériennes supérieures, le DISE (Drug-induced sleep endoscopy), l'OAM (orthèse d'avancement mandibulaire), l'ostéotomie d'avancement bimaxillaire, la pose d'un stimulateur du nerf hypoglosse et le traitement positionnel.

Lamb larynx model for training in endoscopic and CO2 laser-assisted surgeries for benign laryngotracheal obstructions.

PURPOSE: With adequate indication and meticulous execution, endoscopic procedures can efficiently treat a subset of adult and pediatric benign laryngotracheal stenosis and obstructions, but these procedures are precise and very demanding. The difference between a successful and a failed surgery, with potentially debilitating side effects, resides in small details. The learning curve is long and very few centers worldwide have a sufficient case load making adequate training difficult. While indications and concepts of endoscopic procedures can be learned in books and by observing trained colleagues, the dexterity and the precise realization need to be practiced, ideally not initially on patients. METHODS: We describe here the lamb model system for the initial training in such procedures. We provide a step-by-step guide for endoscopic approaches intended to treat pathologies such as laryngomalacia, bilateral vocal fold paralysis, posterior glottic stenosis, and laryngotracheal clefts. CONCLUSIONS: The lamb model system does not pose ethical issues, and it is easy to obtain and to handle. It was used during an international training course for laryngotracheal stenosis by novice and advanced airway surgeons. It was unanimously judged as relevant and useful by the participants.

Temporary tracheal stenting using endovascular prosthesis in the management of severe refractory stenosis following slide tracheoplasty.

OBJECTIVES: To evaluate the role of endovascular stents in temporary tracheal stenting and endoscopic treatment strategy for patients with severe refractory tracheal stenosis following slide tracheoplasty. METHODS: Two patients had severe tracheal stenosis after slide tracheoplasty for long segment congenital tracheal stenosis. Both these patients were managed endoscopically and an endovascular prosthesis was used to temporarily stent the trachea. Short and long term results were evaluated clinically and with repeated endoscopies. RESULTS: The 2 patients had an excellent recovery immediately after the stent placement and continue to have an optimal, age-appropriate stable tracheal diameter after stent removal. CONCLUSION: Endovascular stents can be temporarily used to stent the trachea in the endoscopic treatment strategy to correct refractory severe tracheal stenosis following slide tracheoplasty.