Extended cricotracheal resection with posterior costochondral grafting for complex pediatric subglottic stenosis

Grub, Jaime Penchyna; Hernández, Enrique Ortíz; Teyssier-Morales, Gustavo; Rivera, Iván Rivas; Preciado, Diego; Álvarez-Neri, Hiram

doi:10.1016/j.ijporl.2016.06.055

Cited by 8 publications

(3 citation statements)

References 15 publications

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“…In the present study overall decannulation rate was 86% during the study period with 72% of children being decannulated after one single open airway procedure and over 80% of the cases represented Grade III and IV stenosis. This is comparable to other reports for the pediatric population 1 , 3 , 12 , 13 and also to adult populations being treated for airway stenosis. 14 The relatively worse results obtained for the Grade IV cases in this series when compared to the literature may have been biased by the relative low number of Grade IV cases and also by the fact that this is a relatively new airway team.…”

Section: Discussionsupporting

confidence: 89%

Pediatric airway reconstruction: results after implementation of an airway team in Brazil

Maunsell¹,

Lacerda²,

Prata³

et al. 2020

Brazilian Journal of Otorhinolaryngology

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Section: Discussionsupporting

confidence: 89%

Pediatric airway reconstruction: results after implementation of an airway team in Brazil

Maunsell¹,

Lacerda²,

Prata³

et al. 2020

Brazilian Journal of Otorhinolaryngology

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“…Because of the above‐mentioned difficulties, a definitive surgical solution is usually delayed for years, although an early tracheostomy is often unavoidable . The most common surgical solutions (CTR/ECTR, PCTR, LTR) are recommended in general from the age of 1 year . The youngest PCTR patient described was a 1‐month‐old infant without any comorbidity .…”

Section: Discussionmentioning

confidence: 99%

“…[21][22][23][24] The most common surgical solutions (CTR/ECTR, PCTR, LTR) are recommended in general from the age of 1 year. 4,11,14,15,[21][22][23][24][25][26][27] The youngest PCTR patient described was a 1-month-old infant without any comorbidity. 22 However, even though the overall decannulation rate after CTR is over 80% -the rate of reoperation is between 4-41%, depending on the grade of the stenosis and the comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Slide laryngotracheoplasty for congenital subglottic stenosis in newborns and infants

et al. 2019

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Objectives Subglottic stenosis is the most common laryngeal anomaly necessitating tracheostomy in early childhood. Crico‐ and laryngotracheal resection and laryngotracheal reconstruction—usually with autologous cartilage graft implantation—are the most effective treatments. These surgical techniques are obviously challenging in neonatal age and infancy. However, a reconstructive surgery performed at early age may prevent the sequel of complications. Methods The authors present their novel surgical method for congenital subglottic stenosis. Seven infants had inspiratory stridor; two of them had to be intubated and one required tracheostomy. Laryngotracheoscopy, CT or MRI revealed subglottic stenosis: Cotton‐Myer grade II in one, and grade III in six cases. Slide laryngotracheoplasty was performed before 5 months of age (10–130 days), with a follow‐up period of average 36 months (4–80 months). Phoniatry and quality of life questionnaire were used for evaluation of postoperative results. Results Slide laryngotracheoplasty in the neonatal age made the temporary tracheostomy unnecessary. All babies remained intubated for 3 to 10 days with an uncuffed tracheal tube. After extubation, no dyspnea or swallowing disorder occurred. A subjective quality of life questionnaire, laryngotracheoscopy, clinical growth charts showed satisfactory functional results. Conclusions Single‐stage slide laryngotracheoplasty might be a favorable solution for subglottic stenosis, even in early childhood. In one step, the airway can be maintained without stenting and tracheostomy. Level of Evidence 4 Laryngoscope, 130:E199–E205, 2020

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Complications associated with costal cartilage harvest in pediatric laryngotracheal reconstruction

Lava

Martin

Leonard

et al. 2023

Laryngoscope Investig Oto

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Objective We aimed to determine the rate of complications associated with autologous costal cartilage graft harvest for pediatric laryngotracheal reconstruction (LTR). Secondarily, we sought to identify risk factors associated with the harvest of autologous costal cartilage, as well as evaluate management strategies. Data Sources An electronic database search of Ovid MEDLINE, Ovid EMBASE, and PubMed was completed for articles pertaining to complications in autologous costal cartilage harvest for pediatric LTR. Review Methods This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) 2020 guidelines. The study characteristics, operative information, and patient demographics were collected. The data concerning postoperative complications, risk factors, and management strategies were collected and analyzed for patterns. Results A total of 31 manuscripts representing 745 patients were included for analysis. The reported donor site complications included pneumothorax ( n = 13, 1.74%), pleural tear ( n = 5, 0.67%), infection ( n = 8, 1.07%), and scar‐related problems ( n = 2, 0.26%). There were no reported cases of seroma, persistent pain, or chest wall deformity. Only five studies discussed the management of donor site complications, with intervention in 11 (39.28%) patients including chest tube drainage and steroid injection. Conclusion There is significant variability in the literature regarding complication rates in autologous costal cartilage harvest for pediatric LTR. The incidence of major postoperative complications is low and supports the use of autologous costal cartilage as graft material for pediatric LTR. Level of Evidence NA.

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Extended cricotracheal resection with posterior costochondral grafting for complex pediatric subglottic stenosis

Cited by 8 publications

References 15 publications

Pediatric airway reconstruction: results after implementation of an airway team in Brazil

Pediatric airway reconstruction: results after implementation of an airway team in Brazil

Slide laryngotracheoplasty for congenital subglottic stenosis in newborns and infants

Complications associated with costal cartilage harvest in pediatric laryngotracheal reconstruction

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