Management of adult laryngotracheal airway problems

Abstract

In this review, publications relevant to management of adult laryngotracheal airway problems that have emerged in the last year will be evaluated. As we know, adults with laryngeal and tracheal stenosis often require multiple endoscopic or open reconstructive procedures and may ultimately become tracheotomy dependent or succumb to their disease. Current management of these disease processes has not changed significantly in the last 10 years. Open reconstructive techniques are used if patients fail endoscopic management or if the lesion is not amenable. Endoscopic therapy has focused primarily on some form of laser treatment with dilatation. A number of adjunctive therapies have been entertained, but none has gained widespread use. The canine model of subglottic stenosis that has been developed allows testing of new agents as adjuncts to laser treatment. Mitomycin-C is an antibiotic with antitumor activity that is used in chemotherapy and also in ophthalmologic surgery due to its known inhibition of fibroblast proliferation. Recent studies indicate this drug to have significant potential for improving our current management of this disease process.