Experience with one-stage laryngotracheal reconstruction.
Eight patients (ages 10 months to 5 years) underwent laryngotracheal reconstruction (LTR) without intraluminal stenting or tracheostomy. All patients had moderate to severe acquired or congenital subglottic stenosis. Six patients were tracheostomy-dependent prior to reconstruction. The other two children were intubated and would have required tracheostomy for airway control. LTR and decannulation/extubation were accomplished as a one-stage procedure. Autologous rib cartilage was used (anterior graft only--6 patients, anterior and posterior graft--3 patients) and patients were intubated for 7-10 days. Pulmonary complications from the week-long intubation and intensive care unit stay were common, but easily managed. Seven of eight patients were successfully decannulated/extubated.
Stenson
K
K
Department of Otolaryngology-Head and Neck Surgery, University of Illinois College of Medicine, Chicago 60612.
Berkowitz
R
R
McDonald
T
T
Gruber
B
B
D002356:Cartilage / Q000637:transplantation*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000295:instrumentation; D007829:Laryngostenosis / Q000601:surgery*; D008297:Male; D011014:Pneumonia / Q000209:etiology; D011183:Postoperative Complications; D001261:Pulmonary Atelectasis / Q000209:etiology; D013536:Suture Techniques; D014135:Tracheal Stenosis / Q000601:surgery*; D014139:Tracheostomy / Q000534:rehabilitation; D014143:Traction; D016896:Treatment Outcome; D014831:Voice; D014945:Wound Healing