[Postoperative management following single-stage laryngotracheoplasty in acquired subglottic stenosis in children].
Acquired laryngotracheal stenosis (ALTS) in children is a more and more common disease, following the widespread adoption of prolonged endotracheal intubation for respiratory support, specially among newborn and premature infants with respiratory distress syndrome. Several treatment procedures have been described in order to solve this problem; some authors have recently reported encouraging results with single-stage laryngotracheoplasty, making open reconstruction with airway division, cartilage grafts when appropriate, and closure of the tracheotomy tract at the same operation, followed by a short period of endotracheal intubation, avoiding the need for prolonged laryngeal stenting with its associated risks of granulation tissue formation, restenosis and airway obstruction, and with no need of new surgical procedures. Two patients of 9 and 16 months of age underwent successfully the surgical technique described above, with no need of laryngeal stent; postoperative management required several issues in order to prevent an accidental extubation during the time of scarring of the laryngotracheoplasty. No complications occurred. Follow-up at 6 and 12 months after operation was normal, both ventilation and voice quality.
Morillo
P
P
UCI Pediatría, Hospital Ramón y Cajal, Madrid.
Vázquez
J L
JL
Barberá
R
R
Ros
P
P
Lozano
C
C
D005260:Female; D006801:Humans; D007223:Infant; D007829:Laryngostenosis / Q000601:surgery*; D011182:Postoperative Care; D013997:Time Factors; D014135:Tracheal Stenosis / Q000601:surgery*
Manejo postoperatorio de la reconstrucción laringotraqueal en un solo tiempo en la estenosis subglótica adquirida en el niño.