Long-term outcome after external tracheal stabilization due to congenital tracheal instability.
BACKGROUND
Long-segment tracheobronchial malacia may cause life-threatening dysfunction of the airway system at different levels. This study presents the long-term follow-up (1992 through 2008) of patients who received surgical treatment with external tracheal stabilization in our institution.


METHODS
Eleven patients fulfilled the inclusion criteria. In surviving patients who presented for reexamination, pulmonary function testing, ergometry, and magnetic resonance imaging (MRI) were performed.


RESULTS
All patients could be weaned from the ventilator and discharged. Patients were aged a median 11 months (range, 3 to 48 months) at operation for tracheal compression. Age at follow-up was 9.1 years (range, 0.5 to 16.3 years). Median follow-up was 7.3 years (range, 0.1 to 15.1 years). Postoperatively, 1 patient was lost to follow-up, and 4 died at 2.6 years (range, 0.5 to 6.6 years) of comorbidities. Pulmonary function testing showed a moderate residual airflow restriction, with maximal vital capacity at 75% of normal (range, 45% to 92%). Treadmill exercise testing demonstrated 70% to 89% of the expected normal values for age. Magnetic resonance imaging examination confirmed tracheal patency, but the lumen of the left main bronchus in 2 patients was 50% smaller than on the right. Diaphragmatic motion was normal in all patients.


CONCLUSIONS
Children with congenital tracheal stenosis benefit from external tracheal stabilization. Survival in patients after external tracheal stabilization is significantly influenced by concomitant conditions.
Ley
Sebastian
S
Diagnostic and Interventional Radiology, Section of Pediatric Radiology, University Children's Hospital, Im Neuenheimer Feld 430, Heidelberg, Germany. ley@gmx.net
Loukanov
Tsvetomir
T
Ley-Zaporozhan
Julia
J
Springer
Wolfgang
W
Sebening
Christian
C
Sommerburg
Olaf
O
Hagl
Siegfried
S
Gorenflo
Matthias
M
D001999:Bronchoscopy; D002675:Child, Preschool; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D012129:Respiratory Function Tests; D014132:Trachea; D055090:Tracheomalacia / Q000151:congenital* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*
D011138:Polytetrafluoroethylene