The purpose of this study was to review the incidence, risks, management, and outcomes of nontumoral
laryngeal stenosis after supracricoid partial
laryngectomy (SCPL) in a case series of 376 consecutive SCPLs performed at 1 institution from 1975 to 1995 with a minimum of 3 years of follow-up. Post-SCPL nontumoral symptomatic
laryngeal stenosis was defined as an inability to decannulate patients before the 60th postoperative day (group 1) or the development of
dyspnea (in patients without local recurrence) after an initial period of prolonged, successful decannulation (group 2). Of 376 SCPLs performed, nontumoral symptomatic
laryngeal stenosis developed in 14 (3.7%). There were 7 patients (1.85%) in group 1 and 7 patients (1.85%) in group 2. In univariate analysis, none of the following variables appeared to be statistically related to the risk of immediate
stenosis (group 1): age, gender, comorbidity,
diabetes mellitus, symptomatic
gastroesophageal reflux,
arteritis, preoperative
radiotherapy, arytenoid cartilage
disarticulation, type of reconstruction performed, and postoperative
radiotherapy. A delayed
laryngeal stenosis (group 2) was statistically more likely to occur if the reconstruction performed at the time of SCPL was a cricohyoidopexy (p = .01). Successful management of the
laryngeal stenosis without permanent
tracheostomy was achieved in 5 group 1 patients and 3 group 2 patients. We believe that
stenosis in group I patients arose through technical error, whereas group 2 patients seemed to suffer from problems of healing, mainly cicatricial narrowing of the airway at the site of the cricohyoidal impaction, or pexis. As a result, whereas
laryngeal stenosis in group 1 patients was usually more easily correctable through dilation,
laser incision, or resection of redundant tissue or revision of the impaction,
laryngeal stenosis in group 2 patients presented a more difficult and frustrating complication. The management and outcomes of these patients are presented.