title: Characteristics and surgical outcome of 98 infants and children surgically treated for a laryngotracheal stenosis after endotracheal intubation: excellent outcome for higher grades of stenosis after SS-LTR.
abstract: BACKGROUND
  To describe the characteristics and surgical outcome of 98 infants and children treated for an acquired laryngeal stenosis after intubation for respiratory support.
  
  
  METHODS
  We retrospectively reviewed our data from the last 18 years (1994-2013) concerning infants and children with an acquired laryngotracheal stenosis who were treated in our hospital with a laryngotracheal reconstruction or a cricotracheal resection. Outcome was defined by decannulation ratio.
  
  
  RESULTS
  Of the 98 infants and children who were studied, 54% were preterm, 18% neonates, 13% infants and 14% children. Ninety-one SS-LTR's, two DS-LTR's and five CTR's were performed as primary surgery; three revision operations were performed (DS-LTR). Seventy-seven children had a tracheostomy prior to surgery; decannulation ratio was 93% after primary surgery and 95% after inclusion of revision surgery. For SS-LTR, the decannulation ratio was 93%, including grade III stenosis with comorbidities. Male sex and glottic involvement of the stenosis are correlated to failure of decannulation. Intubation in the term neonatal period is correlated to complicated post-operative course after SS-LTR.
  
  
  CONCLUSIONS
  Excellent results of surgery for acquired laryngotracheal stenosis can be obtained with a high decannulation rate. Even for higher grades of stenosis with comorbidities and glottic involvement, an SS-LTR is an effective surgical treatment for acquired laryngeal stenosis.
authors.affiliation: Department of Otorhinolaryngology, Erasmus Medical Center, Sophia Children's Hospital, The Netherlands. Electronic address: b.pullens@erasmusmc.nl.
authors.forename: B
authors.initials: B
authors.lastname: Pullens
authors.affiliation: Department of Otorhinolaryngology, Erasmus Medical Center, Sophia Children's Hospital, The Netherlands.
authors.forename: L J
authors.initials: LJ
authors.lastname: Hoeve
authors.affiliation: Department of Otorhinolaryngology, Erasmus Medical Center, Sophia Children's Hospital, The Netherlands.
authors.forename: M K
authors.initials: MK
authors.lastname: Timmerman
authors.affiliation: Department of Otorhinolaryngology, Erasmus Medical Center, Sophia Children's Hospital, The Netherlands.
authors.forename: M P
authors.initials: MP
authors.lastname: van der Schroeff
authors.affiliation: Department of Pediatrics, Intensive Care Unit, Erasmus Medical Center, Sophia Children's Hospital, The Netherlands.
authors.forename: K F M
authors.initials: KF
authors.lastname: Joosten
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007829:Laryngostenosis / Q000209:etiology / Q000601:surgery*; D007830:Larynx / Q000601:surgery*; D008297:Male; D009426:Netherlands; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D014132:Trachea / Q000601:surgery*; D014135:Tracheal Stenosis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Children; Cricotracheal resection; Laryngotracheal reconstruction; Laryngotracheal stenosis; Surgical results