The anterior mediastinal approach for management of tracheomalacia

Low cervical skin crease approach for superior sternal cleft repair

“…In contrast, isolated superior sternal cleft may be satisfactorily repaired using a low cervical skin incision approach. This approach has been successfully adopted in infants undergoing tracheopexy or aortopexy, where direct access to the anterior mediastinum was obtained by midline manubrial split [6].…”

The role of airway stenting in pediatric tracheobronchial obstruction☆

“…Filler et al reported an 80% failure rate in cases of TBM and isolated bronchomalacia [16]. Pexy operations can be done with other mediastinal vessels, such as the pulmonary arteries, or even with the trachea and main bronchi, but experience is short and information scarce [18,19].…”

Tracheomalacia in oesophageal atresia: morphological considerations by endoscopic and CT study☆

“…Our analysis of the results, therefore, permits us to draw some conclusions: (a) OA exhibits a high number of morphological variations of the mediastinal structure, some of which are not clinically influential; (b) the use of routine airway assessment by endoscopic procedure is mandatory in all cases of OA before the fourth month of life, and in TM positive cases CT examination was carried out using axial helical computed tomography with a contrast medium; (c) correction of the TM cannot be always effected using a standard operation that does not include consideration of any multiform structural anomalies of the mediastinum, and for this reason we always recommend a surgically 'tailored' approach based on the endoscopic and radiology findings; (d) corrective surgery must be performed using one 'window of access' to the airway, differently from Gross' traditional approach, and we think that the use of a low cervical incision with a split of the sternal manubrium, as recommended by some surgeons [20,21], meets this need better; (e) the importance of the use of intraoperative broncoscopy in the correction of a TM.…”