title: Laryngotracheoplasty to avoid tracheostomy in neonatal and infant subglottic stenosis.
abstract: OBJECTIVE
  To outline the authors' experiences with performing laryngotracheoplasty as an alternative to tracheostomy in neonates and infants with symptomatic subglottic stenosis (SGS).
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  A tertiary referral pediatric hospital.
  
  
  METHODS
  Patients younger than 12 months undergoing single-stage laryngotracheoplasty for SGS at the authors' institution over a 3-year period.
  
  
  RESULTS
  Ten patients (8 boys and 2 girls) underwent single-stage laryngotracheoplasty during the study period. There were 9 cases of acquired SGS and 1 case of congenital SGS. Eight patients had grade III SGS, and 2 patients had grade II SGS. In 9 of 10 patients, the procedure performed was an anterior cricoid split (ACS) and posterior cricoid split (PCS), with the placement of an anterior thyroid ala cartilage graft. One patient underwent ACS and PCS with the placement of a posterior rib cartilage graft, in combination with a right vocal cord lateralization. The mean period of intubation after surgery was 6.8 days (range, 5-9 days). Nine of 10 patients had a complete resolution of their airway symptoms following airway surgery, with a mean duration of follow-up of 305 days (range, 30-780 days). One patient required the placement of a tracheostomy tube 69 days postoperatively due to a failure to wean from ventilation in the setting of multiple comorbidities.
  
  
  CONCLUSIONS
  Laryngotracheoplasty is a safe and effective alternative to long-term tracheostomy in infants and neonates with symptomatic SGS.
authors.affiliation: Princess Margaret Hospital for Children, Perth, Western Australia. antoconnor@ireland.com
authors.forename: Tony E
authors.initials: TE
authors.lastname: O'Connor
authors.forename: Darin
authors.initials: D
authors.lastname: Bilish
authors.forename: David
authors.initials: D
authors.lastname: Choy
authors.forename: Shyan
authors.initials: S
authors.lastname: Vijayasekaran
mesh_terms: D001724:Birth Weight; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D058753:Laryngoplasty / Q000379:methods*; D007829:Laryngostenosis / Q000601:surgery*; D008297:Male; D014139:Tracheostomy; D016896:Treatment Outcome