Pediatric laryngotracheal reconstruction with cartilage grafts and endotracheal tube stenting: the single-stage approach.

Abstract

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.