Tracheal resection and anastomosis: an 11 year management outcome

To evaluate the etiology, perioperative management and outcome of surgery in cases of tracheal stenosis. This was a retrospective analysis of patients with tracheal stenosis who underwent resection with anastomosis from January 2000 until December 2010. Ten patients, aged between 15 to 53 years old [mean of 34.4 years] were included. Post intubation injury was the major cause of tracheal stenosis [n=8], followed by external laryngeal trauma [n=2]. Using the Cotton-Myer classification, 60% of patients had Grade III stenosis whilst 40% had Grade IV stenosis. Intravenous corticosteroids were given 24 hours before extubation. Four patients were well post- operatively without complications. The most common complication in the other patients was granulation tissue in the anastomosis region [n=3], vocal cord paresis [n=2] and one restenosis [n=1]. Four of these patients underwent examination under anesthesia with removal of granulation tissue and/or laser dilatation. However, 2 cases needed Shian Lee operation and required T-tube until present. The success rate for tracheal resection and anastomosis is taken as the number of patients successfully decannulated, which was 80%. Tracheal resection with end-to-end anatomosis was a successful procedure for cervical tracheal stenosis, with low mortality and few complications related to it

A rare case of laryngeal Kaposi’s sarcoma.

Kaposi’s sarcoma (KS) is the most common malignancy observed in patient with acquired immune deficiency syndrome (AIDS). It rarely causes upper airway obstruction. We report a 39-year-old gentleman, a former intravenous drug user with AIDS and Hepatitis C positive who developed progressive hoarseness with stidor. He underwent an emergency tracheostomy and direct laryngoscopy revealed a whitish globular laryngeal mass obscuring the glottic region. A biopsy of the mass was taken and the histopathological report showed evidence of spindle cell connective tissue, consistent with Kaposi’s sarcoma. It is important for clinicians or surgeons to maintain a high index of suspicion for the diagnosis of laryngeal KS in immunodeficiency patient even without cutaneous manifestation.