Laryngotracheal reconstruction in congenital laryngeal webs and atresias.
OBJECTIVE
To review the role of open laryngotracheal reconstruction (LTR) in congenital laryngeal webs and atresias.


METHODS
A retrospective chart review was undertaken in a specialist otorhinolaryngology unit in an academic tertiary referral paediatric hospital. Twenty-one patients with congenital laryngeal subglottic stenosis (SGS) underwent LTR between 1993 and 2003. Two groups were identified; one group had SGS alone (n = 6) and the other group had SGS associated with a laryngeal web (n = 15). Information recorded included presenting features, classification of lesion, surgery performed, and whether decannulation was achieved.


RESULTS
All grades of stenosis (Myer-Cotton classification) and webs of type 2, 3, and 4 (Cohen's classification) were recorded. Fifteen patients had a staged reconstruction and 6 patients had a single-stage LTR. Complications included 2 revision procedures, 3 tracheocutaneous fistulas, and 1 death (cause unrelated). All appropriate patients were successfully decannulated at between 3 and 18 months post-LTR (median, 5 months).


CONCLUSIONS
This series illustrates the effective role of open LTR in both congenital SGS alone and that in association with glottic webbing.
Wyatt
Michelle Elizabeth
ME
Great Ormond Street Hospital, London, UK. michelle.wyatt@btopenworld.com
Hartley
Benjamin Ernest John
BE
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007829:Laryngostenosis / Q000151:congenital* / Q000601:surgery*; D007830:Larynx / Q000002:abnormalities* / Q000601:surgery*; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects; D012086:Reoperation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014132:Trachea / Q000601:surgery*; D016896:Treatment Outcome