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Laryngotracheal Reconstruction Using Microplates in a Porcine Model With Subglottic Stenosis
Author(s) -
Mitskavich Mary T.,
Rimell Frank L.,
Shapiro Andrew M.,
Christopher Post J.,
Kapadia Silloo B.
Publication year - 1996
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-199603000-00011
Subject(s) - subglottis , medicine , airway , larynx , subglottic stenosis , stenosis , cricoid cartilage , surgery , lumen (anatomy) , stent , laryngotracheal stenosis , tracheal stenosis , glottis , radiology
Current techniques of laryngotracheal reconstruction require a choice between prolonged stenting (conventional technique) or short‐term stenting with maintenance of sedation and paralysis until the airway has stabilized(single‐stage laryngotracheal reconstruction). An alternative method is proposed using microplates to provide immediate airway stabilization without stenting. This study was designed to evaluate the long‐term effects of microplate repair of stenosis of the subglottis and trachea on the growing larynx. Subglottic stenosis was produced in piglets using a transoral endoscopic technique. Eight animals underwent repair of the stenosis using an anterior cricoid split with microplate distraction and stabilization of the cricoid cartilage and first tracheal ring. The distraction was maintained and airway growth continued for the duration of this study. However, with growth of the larynx the plates migrated away from their original position. In 50% of the animals followed up for 90 days the plates migrated into the airway lumen. This study suggests that rigid distraction of the stenotic airway with microplates is a viable alternative to more traditional methods of repair. However, plate removal at some interval after surgery is required in the growing larynx in order to prevent migration of the plate into the airway.