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Pediatric laryngotracheal reconstruction with cartilage grafts and endotracheal tube stenting: The single‐stage approach
Author(s) -
Cotton Robin T.,
Myer Charles M.,
O'Connor David M.,
Smith Marshall E.
Publication year - 1995
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 - 10.1288/00005537-199508000-00009
Subject(s) - laryngotracheal stenosis , medicine , surgery , intubation , stenosis , lumen (anatomy) , stoma (medicine) , endotracheal tube , stent , stage (stratigraphy) , single stage , endotracheal intubation , arytenoid cartilage , larynx , airway , tracheal stenosis , radiology , paleontology , biology , engineering , aerospace engineering
Laryngotracheal reconstruction (LTR) comprises five stages: 1, characterization of the stenosis; 2, expansion of the lumen; 3, stabilization of the enlarged lumen framework; 4, healing of the surgical site; and 5, decannulation. Single‐stage LTR (SS‐LTR) combines and compresses stages 3 through 5 (stabilization, healing, and decannulation) into a brief period of postoperative intubation. At Children's Hospital Medical Center in Cincinnati, Ohio, from January 1987 to December 1993,116 reconstructive procedures were performed by using postoperative intubation. Nine were tracheoplasty or stoma‐revision procedures in isolation, leaving 107 SS‐LTR procedures that included the laryngotracheal complex. The use of SS‐LTR has increased to 30% of LTRs performed in 1993. Data are presented on the success of SS‐LTR as measured by the number of decannulations and extubations achieved.