Partial cricotracheal resection for severe upper tracheal stenosis: Potential impacts on the outcome Ahmed Musaad Abd El-Fattah, Hisham Atef Ebada *, Hazem Emam Amer, Mohammed Mohammed Abosamra, Ali Tawfik Mansoura University, Mansoura, Egypt 1. Introduction It is well recognized that upper tracheal and/or subglottic stenosis may be caused by laryngotracheal trauma (endotra- cheal intubation, previous airway surgery or accidental trauma), as well as inflammatory, neoplastic, and idiopathic causes. Prolonged endotracheal intubation remains the cause of stenosis in more than 90% of patients [1,2]. The surgical options for treatment of laryngotracheal stenosis include intraluminal procedures (dilatation, stent placement, and laser surgery), laryngotracheoplasty (frame- work expansion by anterior or posterior grafting), and tracheal or cricotracheal resection with primary anastomosis [2]. Al- though dilatation and laser surgery are well tolerated safe procedures, the results are usually temporary. The recurrence of symptoms is frequent and requires repeated procedures without a satisfactory final result [3]. Unfortunately, life-long tracheos- tomy may be the only treatment option in poor surgical risk patients [4]. Auris Nasus Larynx xxx (2017) xxx–xxx * Corresponding author. E-mail address: hishamebada@hotmail.com (H.A. Ebada). A R T I C L E I N F O Article history: Received 27 January 2017 Accepted 14 March 2017 Available online xxx Keywords: Tracheal resection Cricotracheal resection Anastomosis Outcome A B S T R A C T Objective: The aim of this study was to investigate the potential impact of multiple preoperative and intraoperative variables on the outcome of partial cricotracheal resection and tracheal resection anastomosis (PCTR/TRA). Methods: The study was conducted on 35 consecutive patients of grade III and IV upper tracheal stenosis with or without subglottic involvement. The indication of PCTR/TRA was post intubation stenosis in all patients. Overall complications (major and minor) occurred in 18 patients. Perioperative mortality occurred in 1 patient. Anastomotic complications do not always mean failure of surgery. They may indicate one or more interventions; such as removal of granulation tissue or dilatation of restenosis, with good results in most cases. Results: At the end of treatment, 30 (85.7%) patients were decannulated successfully with effortless breathing and with good phonation and swallowing. Several perioperative factors were found to have a significant impact on the outcome of PCTR/TRA. Of these factors, comorbidities had the most significant negative impact, and indeed all the three patients who had comorbidities, were not successfully decannulated. Duration of intubation, length of resected segment and previous open airway interventions was reported to have a significant negative impact on the outcome of surgery. Conclusion: PCTR/TRA for treatment of post traumatic subglottic or upper tracheal stenosis has a high success rate, especially in healthy patients without comorbidities, and without previous open airway interventions. © 2017 Elsevier B.V. All rights reserved. G Model ANL-2266; No. of Pages 7 Please cite this article in press as: El-Fattah AMA, et al. Partial cricotracheal resection for severe upper tracheal stenosis: Potential impacts on the outcome. Auris Nasus Larynx (2017), http://dx.doi.org/10.1016/j.anl.2017.03.014 Contents lists available at ScienceDirect Auris Nasus Larynx jo u rn al h om epag e: ww w.els evier.c o m/lo cat e/anl http://dx.doi.org/10.1016/j.anl.2017.03.014 0385-8146/© 2017 Elsevier B.V. All rights reserved.