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Benign disease

Surgical Management of Tracheoesophageal Fistula

This written and video case review from Osho and colleagues centers on a 54-year-old woman who suffered smoke inhalation injury as a result of a house fire. Following prolonged intubation, mechanical ventilation, open tracheostomy tube placement, and recurrent pneumonia, the patient was diagnosed with a tracheoesophageal fistula (TEF). The authors prefer to manage TEF via an anterior cervical approach with division of the trachea, though a right thoracotomy may be used in the setting of highly distal TEFs.

Functional Outcome After (Laryngo)tracheal Resection and Reconstruction for Acquired Benign (Laryngo)tracheal Stenosis

Timman and colleagues assessed the functional outcomes of patients who underwent laryngotracheal resection (LTR) and reconstruction for benign laryngotracheal stenosis. Between 1996 and 2017, 119 consecutive patients underwent LTR (n = 47) or end-to-end segmented tracheal resection (n = 56). There was consistent functional improvement during follow-up, particularly with respect to the sensation of dyspnea during exercise and the reduction of inspiratory stridor, although early voice alterations without recurrent nerve palsy were reported more often after LTR (34% versus 16%).

A Reassessment of Tracheal Substitutes: A Systematic Review

This systematic review by Udelsman and colleagues assesses the clinical successes and setbacks of the current methods of airway replacement. Twenty-one studies, focusing primarily on the clinical translation of circumferential or near circumferential tracheal substitutes, were included in the final assessment. A total of 41 patients were identified as having received allotransplantation, autologous tissue reconstruction, bioprosthetic reconstruction, or tissue engineered reconstruction between January 2000 and October 2017.

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