González GJA, González SJG, Navarro MMC, Alemán GP

Language: Spanish
References: 23
Page: 161-166
PDF size: 424.59 Kb.

ABSTRACT

Background: Intubation is the most common cause of laryngotracheal stenosis, which accounts for 90% of cases. Treatment includes dilatation, steroid injection, low tracheotomy, laser microsurgery, interdigitated tracheoplasty, radiated incisions, hioides bone transposition, costal and septal cartilage.
Objective: To explore the proposal of a new form of treatment for subglotic stenosis based on tisular distraction, where it is pretended to promote the growing of tissues in a controlled and guided way by spaces surgically created.
Material and methods: In five dogs of Creole breed and medium size, a prosthesis of silicone modeled in rhomboidal form silastic of medium medical degree, Dow Corning NS 802, whose longitudinal and transverse axes adapt and contain the borders free of a laryngotracheofisura of partial created between the second and fifth tracheal rings; this open space expands the subglotic diameter. Fissure is of the partial thickness because it do not shine the trachea light, it just cover the tracheal external pericondrio and tracheal rings not affecting internal mucopericondrio, which avoids the need of tracheostomy. Finally, neocartilaginous and fibrous tissue growing will be promoted by a space in a windows form on the posterior side of prosthesis through its minor axis, in order to it supports the borders of the fissure, and thus maintains the new diameter of tracheal tube. This lets in a medium term the retirement of the prosthesis without risk of collapse.
Results:All animals implanted survived to the procedure without needing tracheostomy and developed bridges of tisular distraction in the window of the prosthesis. Histology of bridges showed metaplasic fibrous tissue with cells of type inflammatory, fibroblasts and condroblasts.
Conclusions: Tisular distraction technique in trachea is a viable option in the treatment of subglotic stenosis.

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