Reconstructive and plastic treatment of extensive laryngotracheostomy following mine blast injury

BACKGROUND: The nature of combat operations in modern military conflicts is leading to an increase in the number of casualties due to mine blast trauma. Combat wounds to the neck are often associated with damage to the larynx and trachea, resulting in scarring airway stenosis. Surgery is the primary treatment for chronic scarring stenosis of the larynx and trachea. However, despite the large number of surgical techniques, not all of them are effective. Anatomic features of the larynx and trachea, difficulties in maintaining the formed airway lumen in most cases lead to postoperative restenosis of the larynx and trachea, which significantly reduces the effectiveness of surgical treatment and complicate the rehabilitation of the patient.

CLINICAL CASE DESCRIPTION: This article presents the experience of treating an extensive laryngotracheal defect resulting from a mine blast injury. A patient with an extensive defect of the anterior wall of the larynx and trachea was admitted to the Department of Reconstructive Surgery of Cavitary Organs of the Neck of L.I. Sverzhevsky Research Clinical Institute of Otolaryngology. After clinical evaluation, laryngotracheoplasty was performed with alloimplant material, followed by stenting of the lumen of the larynx and trachea with a specially developed silicone stent.

CONCLUSION: The use of the most advanced medical technologies allowed to achieve a positive clinical outcome, to reduce the number of stages of surgical treatment, to prevent restenosis of the lumen of the larynx and trachea, to restore breathing through the natural ways of breathing, the physiological process of swallowing and the voice of the patient.