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Full text of "Diseases Of The Nose Throat And Ear"

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LARYNGOTRACHEAL TRAUMA                       197

over a solid stent inlay of silicone rubber which is wired in place for
8 weeks.

Subglottic and Trachea! Stenosis. A very mild case may be managed by
repeated dilatations but such a case is the exception rather than the rule.
Most cases will require excision of the stenosed portion and re-anastomosis of
the trachea. Up to 4 cm of trachea may be excised and a primary repair carried
out by freeing the tracheal stump in the mediastinum down to the carina, and
'dropping* the larynx by dividing the suprahyoid muscles. It is possible to
manage most problems in this way, but if more trachea has to be resected then
the left main bronchus should be removed from the carina, the trachea pulled
up into the neck thus straightening the right main bronchus and the left main
bronchus is reattached to the right main bronchus. If the end-to-end
anastomosis in the neck has been done properly it is doubtful if a tracheostomy
or a stent inlay would help the procedure at all