PATRICK T. GULLANE, MD
TORONTO, CANADA

Postintubation injury of the upper airway commonly results in stenosis of the larynx, subglottis, and adjacent trachea. The traditional approach to surgical correction is a laryngofissure for the laryngeal component and a staged reconstruction of the subglottic stenosis. Between July 1989 and June 2000, 36 patients with combined injuries involving the glottis and subglottis were treated. The age range was from 16 to 72 years, and there was a female predominance. Twenty-nine patients had postintubation injuries. 3 injuries were idiopathic, 2 were from blunt trauma, 1 was inhalational, and 1 was congenital. Stenosis involved the posterior glottis in 27 of the patients and the anterior glottis in 3 patients, and 6 patients had complete glottic stenosis. All patients were managed with a cricotracheal resection, a laryngofissure, and a pedicled membranous tracheal flap. A temporary laryngotracheal stent was maintained after the operation in all cases for a mean averave of 3 months. Of the 36 patients, 31 (87%) have been successfully decannulated. Details of the surgical technique, complications, and limitations are presented. This approach provides superior results to the more traditional staged procedures.