Modern aspects of larynx and trachea prosthesis after reconstructive surgery

E.A. Kirasirova^1,2, N.D. Oltarzhevskaya³, T.S. Khlystova³, M.I. Usova¹, N.V. Lafutkina¹, R.F. Mamedov¹, R.A. Rezakov¹, E.V. Kulabukhov², S.I. Tyutina¹, E.A. Egorova¹

¹Clinical Research Institute of Otorhinolaryngology named after L.I. Sverzhevsky, Moscow

²Pirogov Russian National Research Medical University, Moscow

³Coletex LLC, Moscow

Background: one of the significant stages concerning patient management after reconstructive surgeries of larynx and trachea is the formed airway lumen prosthesis.

Aim: to evaluate the efficacy of the developed sodium alginate hydrogel for the larynx and trachea prosthesis in the treatment of patients with chronic cicatricial stenosis of the larynx and trachea and bilateral laryngeal paralysis.

Patients and Methods: in 2018–2021, 51 patients were examined and treated in the Department of Reconstructive Surgery of Hollow Neck Organs. 30 patients of the main group had the laryngeal and tracheal lumen prosthesis in the intra- and postoperative period using the developed hydrogel tampon. 21 patients of the control group had an elastic or Merocel tampon inserted into the laryngeal-tracheal lumen according to the standard procedure. The article pre sents conducted endoscopic and cytological studies to evaluate the larynx and tracheal prosthesis results with proposed tampon.

Results: according to endoscopy in the main group, there were no inflammatory phenomena after tampon removal and the beginning of epithelialization in the mucous membrane of the larynx and trachea was already established 7 days after surgery. The cytology of inflammatory touch smears was noted up to 5 days. Starting from 6 to 7 days, an inflammatory-regenerative cytogram was noted. According to the results of further follow-up, there was no restenosis of the laryngeal and tracheal lumen. Adding that, implanted allogeneic structures were not rejected. The long-term results of surgical treatment were satisfactory: there were no complications in the postoperative period, repeated surgeries were not required. In the control group, inflammatory phenomena of the postoperative area were observed for 7–12 days after tampon removal. Epithelization of the wounded area began 8 days after surgery. The cytogram with inflammatory activity persisted for 5–10 days after tampon removal from the laryngeal and tracheal lumen. There were complications in 5 patients developed from 2 weeks to 2 months, 4 of them required repeated surgical interventions.

Conclusion: the obtained preliminary data indicated the prospects of intra- and postoperative use of a sodium alginate h ydrogel tampon for prosthesis of the laryngeal and tracheal lumen.

Keywords: larynx, trachea, cicatrical stenosis, prosthesis, reconstructive surgery, sodium alginate.

For citation: Kirasirova E.A., Oltarzhevskaya N.D., Khlystova T.S. et al. Modern aspects of larynx and trachea prosthesis after reconstructive surgery. RMJ. 2022;2:36–40.