Management of Laryngotracheal Stenosis: A 15-year Experience at the University of Maiduguri Teaching Hospital, Northeastern Nigeria

Background: Laryngotracheal stenosis (LTS) is a life-threatening condition characterised by partial or complete cicatricial narrowing of the upper airway at the level of either the supraglottis, glottis, subglottis or trachea. Objective: To review all cases of LTS that presented to our facility and how they were managed. Materials and Methods: A retrospective review of LTS cases was conducted from July 2009 to June 2024. Ten patients’ case records were analysed using SPSS 25.0. Results: The patients were aged between 2.5 and 42 years with a mean age = 22.25 years. There was female preponderance with a ratio of F: M = 2.3:1. Nine (90%) cases were acquired, while 1 (10%) was congenital LTS. Among the acquired cases, 4 (44.4%) were from strangulation injury, 1 (11.1%) from penetrating neck injury following an explosion, 1 (11.1%) from gunshot injury to the neck, 1 (11.1%) from recurrent respiratory papillomatosis, 1 (11.1%) from prolonged intubation and 1 (11.1%) from caustic ingestion. Sites affected were laryngotracheal 2 (20%), laryngeal 1 (10%), supraglottis/glottis 2 (20%), supraglottis 2 (20%), glottis 1 (10%) and subglottis 2 (20%). Six (60%) had laryngoscopic excision in addition to either laryngeal stenting (40%) or dilatation (20%), 2 (20%) had laryngofissure and excision with stenting, while 1 (10%) had laser excision. Seven (70%) were successfully decannulated, 1 (10%) was referred, 1 (10%) died and 1 (10%) was lost to follow-up. Conclusions: Due to its recurrent nature, the management of LTS is quite complex and requires multiple procedures. Treatment should be individualised based on the aetiology, disease severity, surgeons’ expertise and available resources.