The effect of the ratio of tracheal length to narrow tracheal segment length on surgical success in patients with subglottic stenosis

Laryngotracheal stenoses (LTS); It is a heterogeneous group of diseases and is defined as narrowing of the airway lumen diameter at the glottic, subglottic or tracheal level due to idiopathic or secondary causes. Apart from long-term intubation, which is the most common cause; Traumas, corrosive substances, operational errors and congenital causes are other causes of LTS. Laryngotracheal reconstruction (LTR) surgery is a procedure that provides sphincter and phonation functions of the larynx and aims to reconstruct a lumen wide enough for breathing in the laryngotracheal system. In this study, we aimed to investigate the effect of the ratio of tracheal length to narrow tracheal segment length on surgical success, as well as to determine the clinical and radiological factors associated with restenosis, the risk factors for the development of subglottic stenosis, and to determine whether there are patient characteristics that can serve as prognostic indicators of clinical outcomes in this patient population. We analyzed 40 patients who underwent tracheal resection and anastomosis (TRA) for subglottic stenosis after intubation. Tracheotomy history in the preoperative period was found to be an important predisposing factor for the development of restenosis in patients. Although there was no significant difference in the degree of stenosis between the patients who developed restenosis and the patients who did not develop it, 9(81.8%) of 11 patients in the patient group with restenosis could be decannulated, while in the patient group without restenosis, all 29 patients could be decannulated, and this difference between the two groups was statistically significant. Although the reason for intubation, comorbidities, preoperative, stenosis degree and length of stenosis showed significant results in large case series, statistically significant values could not be reached in our study. Likewise, the ratio of tracheal length to narrow segment length was not found to be significant, and we believe that the effect of this ratio on the success of TRA will yield significant results in larger case series.