The use of a laryngotracheal separation procedure in pediatric patients

Abstract

The objective of this study was to review experience, outcome, and satisfaction after a laryngotracheal separation (LTS) procedure in pediatric patients. Chart reviews and phone questionnaires were used. Factors reviewed included hospitalizations and infections prior to and after LTS, morbidity, and impact on quality of life. Twenty-one pediatric patients ranging in age from 8 to 172 months underwent LTS. Follow-up time ranged from 1 to 49 months. Complications were minor. Eighty-eight percent of patients had fewer hospitalizations or were discharged for the first time after LTS. Number of pneumonias and suctioning frequency decreased, mobility increased in patients with prior tracheostomies, and care requirements decreased in 95% of patients. Parents reported satisfaction and improved quality of life. LTS is a low-risk, successful procedure which increases quality of life and decreases morbidity in pediatric patients with irreversible upper airway dysfunction.

Surgery for Aspiration: Analysis of Laryngotracheal Separation in 23 Children

“…Deaths were not a direct result of the surgery but rather a progression of the underlying disease, similar to the reports of others [5,6].…”

“…The success of the procedure in controlling aspiration was 100%, similar to that in other reports [5,6]. No other described technique has such high success rate.…”

“…The main disadvantage of LTS is interruption of vocal production [3], but our inclusion criteria for treatment was that there be no oral communication, similar to almost all other series reported in the literature [5,6].…”

“…Considering all these aspects, the technique of preference in children for many authors [2][3][4][5][6] is laryngotracheal separation (LTS) as modified by Lindeman [7,8]. Lindeman [7] proposed a procedure to control aspiration with the preservation of larynx and the ability to reverse the procedure.…”

Intractable pulmonary aspiration in children: Which operation?

“…Lawless et al [20] reviewed the outcome and satisfaction of laryngotracheal separation performed on 21 children between 1988 and 1992. There was a significant decrease in lower airway infection and in total number of hospitalisation.…”