Laryngotracheoplasty as an alternative to tracheotomy in infants younger than 6 months.
OBJECTIVE
To compare the success rates of laryngotracheoplasty (LTP) with those of anterior cricoid split (ACS) performed over the same period in infants younger than 6 months.


METHODS
Case-control study.


METHODS
Tertiary children's hospital.


METHODS
Thirty-two infants younger than 6 months.


METHODS
Twenty-one infants younger than 6 months underwent single-stage LTP as an alternative to tracheotomy, and the outcomes were compared with those in 11 infants who underwent ACS as an alternative to tracheotomy.


METHODS
Operation-specific success was defined as extubation without subsequent tracheotomy or revision open-airway procedure.


RESULTS
Infants who underwent LTP had a greater percentage of grade 3 subglottic stenosis (71%-99% obstruction) (P = .02, Fisher exact test). Mean age of patients was similar (3.7 months in the LTP group vs 2.8 months in the ACS group) with no significant difference on t test (P = .12). The operation-specific success rate was 81% (17 of 21) in the LTP group and 27% (3 of 11) in the ACS group (P = .006, Fisher exact test).


CONCLUSIONS
Single-stage LTP should be considered the first alternative to tracheotomy when subglottic stenosis is the primary airway lesion. The operation-specific success rate of 81% is comparable to reported operation-specific success rates for LTP in older children.
White
David R
DR
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Ave, PO Box 250550, Charleston, SC 29425, USA. whitedr@musc.edu
Bravo
Miguel
M
Vijayasekaran
Shyan
S
Rutter
Michael J
MJ
Cotton
Robin T
RT
Elluru
Ravindhra G
RG
D016022:Case-Control Studies; D003413:Cricoid Cartilage / Q000601:surgery; D005931:Glottis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007442:Intubation, Intratracheal / Q000009:adverse effects; D007829:Laryngostenosis / Q000601:surgery*; D007830:Larynx / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D012121:Respiration, Artificial / Q000295:instrumentation; D014132:Trachea / Q000601:surgery; D014140:Tracheotomy