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Open paediatric laryngotracheal reconstruction: a five-year experience at a tertiary referral centre

Published online by Cambridge University Press:  21 January 2022

A ElSobki  and
N El-Kholy Open the ORCID record for N El-Kholy [Opens in a new window]
A ElSobki
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
N El-Kholy*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt
*
Author for correspondence: Dr N El-Kholy, Department of Otolaryngology – Head and Neck Surgery, Mansoura University Faculty of Medicine, Elgomhouria St., Mansoura 35516, Egypt E-mail: [email protected]
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Abstract

Objective

Laryngotracheal reconstruction with costal cartilage graft is a cornerstone procedure in treatment of multiple paediatric airway pathologies. The current study aimed to report on the experience of laryngotracheal reconstruction and document post-operative outcomes and complications.

Method

Records of laryngotracheal reconstruction procedures performed between 2016 and 2020 were retrospectively reviewed. Primary indication, clinical data, decannulation rate, voice assessment, need for revision surgery and possible complications were analysed.

Results

A total of 41 patients were treated with laryngotracheal reconstruction. Subglottic stenosis formed the largest percentage of cases followed by congenital glottic web (20 and 14 patients, respectively). Three patients (7.3 per cent) underwent single stage surgery, and the remaining cases had a double stage procedure. Revision laryngotracheal reconstruction was needed in a single case, and 38 out of 39 tracheostomised patients were successfully decannulated.

Conclusion

Favourable outcomes were reported with costal cartilage laryngotracheal reconstruction as a definitive treatment for a large range of paediatric airway problems.

Keywords

LaryngotrachealLaryngeal WebSubglottic StenosisVocal Cord Paralysis
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 2 , February 2023 , pp. 192 - 199
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr N El-Kholy takes responsibility for the integrity of the content of the paper

References

Koempel, JA, Cotton, RT. History of pediatric laryngotracheal reconstruction. Otolaryngol Clin North Am 2008;41:825–35CrossRefGoogle ScholarPubMed
Gustafson, LM, Hartley, BE, Liu, JH, Link, DT, Chadwell, J, Koebbe, C et al. Single-stage laryngotracheal reconstruction in children: a review of 200 cases. Otolaryngol Head Neck Surg 2000;123:430–4CrossRefGoogle ScholarPubMed
Younis, RT, Lazar, RH, Bustillo, A. Revision single-stage laryngotracheal reconstruction in children. Ann Otol Rhinol Laryngol 2004;113:367–72CrossRefGoogle ScholarPubMed
Cotton, RT. Management of subglottic stenosis. Otolaryngol Clin North Am 2000;33:111–30CrossRefGoogle ScholarPubMed
Cotton, RT, Myer, CM 3rd, O'Connor, DM. Innovations in pediatric laryngotracheal reconstruction. J Pediatr Surg 1992;27:196–200CrossRefGoogle ScholarPubMed
de Alarcon, A, Rutter, MJ. Cervical slide tracheoplasty. Arch Otolaryngol Head Neck Surg 2012;138:812–6CrossRefGoogle ScholarPubMed
Jacobs, IN, Redden, RA, Goldberg, R, Hast, M, Salowe, R, Mauck, RL et al. Pediatric laryngotracheal reconstruction with tissue-engineered cartilage in a rabbit model. Laryngoscope 2016;126(suppl 1):5–21CrossRefGoogle ScholarPubMed
Jefferson, ND, Cohen, AP, Rutter, MJ. Subglottic stenosis. Semin Pediatr Surg 2016;25:138–43CrossRefGoogle ScholarPubMed
Kopelovich, JC, Wine, TM, Rutter, MJ, Mitchell, MB, Prager, JD. Secondary reverse slide tracheoplasty for airway rescue. Ann Thorac Surg 2016;101:1205–7CrossRefGoogle ScholarPubMed
Rutter, MJ, Hartley, BE, Cotton, RT. Cricotracheal resection in children. Arch Otolaryngol – Head Neck Surg 2001;127:289–92CrossRefGoogle ScholarPubMed
Yamamoto, K, Monnier, P, Holtz, F, Jaquet, Y. Laryngotracheal reconstruction for pediatric glotto-subglottic stenosis. Int J Pediatr Otorhinolaryngol 2014;78:1476–9CrossRefGoogle ScholarPubMed
Balakrishnan, K, Sidell, DR, Bauman, NM, Bellia-Munzon, GF, Boesch, RP, Bromwich, M et al. Outcome measures for pediatric laryngotracheal reconstruction: international consensus statement. Laryngoscope 2019;129:244–55CrossRefGoogle ScholarPubMed
Cohen, SR. Congenital glottic webs in children. A retrospective review of 51 patients. Ann Otol Rhinol Laryngol Suppl 1985;121:2–16CrossRefGoogle ScholarPubMed
De Trey, L, Lambercy, K, Monnier, P, Sandu, K. Management of severe congenital laryngeal webs–a 12 year review. Int J Pediatr Otorhinolaryngol 2016;86:82–6CrossRefGoogle Scholar
Cotton, RT. Pediatric laryngotracheal stenosis. J Pediatr Surg 1984;19:699–704CrossRefGoogle ScholarPubMed
Bogdasarian, RS, Olson, NR. Posterior glottic laryngeal stenosis. Otolaryngol Head Neck Surg (1979) 1980;88:765–72CrossRefGoogle ScholarPubMed
Monnier, P. Airway stenting with the LT-Mold™: experience in 30 pediatric cases. Int J Pediatric Otorhinolaryngol 2007;71:1351–9CrossRefGoogle ScholarPubMed
Fearon, B. Subglottic stenosis in infants and children: the clinical problem and experimental surgical correction. Can J Otolaryngol 1972;1:281–9Google Scholar
Bailey, CM. Surgical management of acquired subglottic stenosis. J Laryngol Otol Suppl 1988;17:45–8Google ScholarPubMed
Cotton, RT, Gray, SD, Miller, RP. Update of the Cincinnati experience in pediatric laryngotracheal reconstruction. Laryngoscope 1989;99:1111–6CrossRefGoogle ScholarPubMed
Ochi, JW, Evans, JN, Bailey, CM. Pediatric airway reconstruction at great ormond street: a ten-year review: i. laryngotracheoplasty and laryngotracheal reconstruction. Ann Otol, Rhinol Laryngol 1992;101:465–8CrossRefGoogle Scholar
Cotton, RT, Myer, CM, 3rd, O'Connor, DM, Smith, ME. Pediatric laryngotracheal reconstruction with cartilage grafts and endotracheal tube stenting: the single-stage approach. Laryngoscope 1995;105:818–21CrossRefGoogle ScholarPubMed
Monnier, P, Savary, M, Chapuis, G. Partial cricoid resection with primary tracheal anastomosis for subglottic stenosis in infants and children. Laryngoscope 1993;103:1273–83CrossRefGoogle ScholarPubMed
Padia, R, Sjogren, P, Smith, M, Muntz, H, Stoddard, G, Meier, J. Systematic review/meta-analysis comparing successful outcomes after single vs. double-stage laryngotracheal reconstruction. Int J Pediatr Otorhinolaryngol 2018;108:168–74CrossRefGoogle ScholarPubMed
Bajaj, Y, Cochrane, L, Jephson, C, Wyatt, M, Bailey, C, Albert, D et al. Laryngotracheal reconstruction and cricotracheal resection in children: recent experience at Great Ormond Street Hospital. Int J Pediatric Otorhinolaryngol 2012;76:507–11CrossRefGoogle ScholarPubMed
Gustafson, LM, Hartley, BE, Cotton, RT. Acquired total (grade 4) subglottic stenosis in children. Ann Otol Rhinol Laryngol 2001;110:16–9CrossRefGoogle ScholarPubMed
Milczuk, HA, Smith, JD, Everts, EC. Congenital laryngeal webs: surgical management and clinical embryology. Int J Pediatr Otorhinolaryngol 2000;52:1–9CrossRefGoogle ScholarPubMed
Monnier, P. A new stent for the management of adult and pediatric laryngotracheal stenosis. Laryngoscope 2003;113:1418–22CrossRefGoogle ScholarPubMed
Ndiaye, I, Van den Abbeele, T, Francois, M, Viala, P, Tanon-Anoh, M, Narcy, P. Surgical management of laryngeal stenosis in children. Ann Otolaryngol Chir Cervicofac 1999;116:143–8Google ScholarPubMed
Wyatt, ME, Hartley, BE. Laryngotracheal reconstruction in congenital laryngeal webs and atresias. Otolaryngol Head Neck Surg 2005;132:232–8CrossRefGoogle ScholarPubMed
Agrawal, N, Black, M, Morrison, G. Ten-year review of laryngotracheal reconstruction for paediatric airway stenosis. Int J Pediatr Otorhinolaryngol 2007;71:699–703CrossRefGoogle ScholarPubMed
de Alarcon, A, Rutter, MJ. Revision pediatric laryngotracheal reconstruction. Otolaryngol Clin North Am 2008;41:959–80CrossRefGoogle ScholarPubMed
Li, L, Black, K, White, M, Zalzal, G, Preciado, D. An evaluation of arytenoid prolapse following laryngotracheal reconstruction. Laryngoscope 2020;130:247–51CrossRefGoogle ScholarPubMed
Rizzi, MD, Thorne, MC, Zur, KB, Jacobs, IN. Laryngotracheal reconstruction with posterior costal cartilage grafts: outcomes at a single institution. Otolaryngol Head Neck Surg 2009;140:348–53CrossRefGoogle ScholarPubMed
Hart, CK, Richter, GT, Cotton, RT, Rutter, MJ. Arytenoid prolapse: a source of obstruction following laryngotracheoplasty. Otolaryngol Head Neck Surg 2009;140:752–6CrossRefGoogle ScholarPubMed