Neodymium: YAG laser in the management of tracheal stenosis.

Thirty-five cases of benign stenotic lesions involving the upper respiratory passages were managed by laser photocoagulation of the scar tissue. The stenosed segment was around the site of tracheostomy in 28 cases (80%), subglottic in five cases (14.3%), and as a result of congenital webs, at the level of the larynx in two cases (5.7%). Adequate lumen was achieved in 29 cases (83%). The procedure was unsuccessful in five patients (all with subglottic stenosis). One to 11 laser settings (mean 2.8) were required to achieve satisfactory lumen. Complications (three cases, 8.5%) included bleeding in two cases and cervical emphysema in one case. Patients have been followed-up for two to 34 months (mean 23 months). One patient (2.8%) had recurrent stricture formation for which recanalisation was done. There were no procedure-related deaths. Neodymium: Yttrium-Aluminium-Garnet (Nd: YAG) laser photocoagulation is effective in the management of tracheal stenosis due to benign lesions except when they are located in the subglottic region. It carries minimal morbidity and no mortality risks.