Single-stage laryngotracheal reconstruction for the treatment of subglottic stenosis in children

Abstract

Summary Introduction: In recent decades, airway reconstruction has become the treatment of choice for subglottic stenosis (SGS) in children, which is performed in either single or multiple stages. However, there is evidence in the literature that single-stage surgery is more effective. Objective: To evaluate the success rate of single-stage laryngotracheoplasty (LTP) and cricotracheal resection (CTR) in patients that were treated in our hospital. Materials and Method: We performed a retrospective study of children undergoing laryngotracheal reconstruction. Results: Twenty-four children were included. The etiology of SGS was postintubation in 91.6% and congenital in 8.3%. One patient (4.2%) had grade 4 SGS, 17 (70.8%) presented with grade 3 SGS, 4 (16.6%) had grade 2 SGS, 1 (4.2%) had grade 3 SGS associated with glottic stenosis, and 1 (4.2%) had grade 3 SGS with tracheal stenosis. We performed 26 LTPs and 3 CTRs. Decannulation rates were 66% in the CTR procedures and 85.7% in the LTP procedures; the overall decannulation rate was 83.3%. All children presented with fever in the postoperative period, but were afebrile after the tube was removed. Conclusion: Our series showed a decannulation rate of 83.3%.

Single stage cricoid split laryngoplasty with costochondral rib grafting is a novel approach to treat subglottic stenosis in a paediatric patient: A case report

“…These are frequently complicated cases that require multiple methods of therapy to fully cure. A few factors need to be taken into account, such as the patient's neurological condition, nature, location, and severity of the stenosis, the level of airway obstruction, and the existence of vocal cord damage [ 6 ].…”

Emerging polymeric material strategies for cartilage repair

“…43,46,49 Subglottic stenosis has been treated through laryngotracheoplasty with cartilage grafts (e.g., costal cartilage). [50][51][52][53] However, graft availability is limited (notably for pediatric patients), there are concerns for donor site morbidity, and stenosis length can increase complications. 50,51,54,55…”

“…[50][51][52][53] However, graft availability is limited (notably for pediatric patients), there are concerns for donor site morbidity, and stenosis length can increase complications. 50,51,54,55…”

Ultra‐High Modulus Hydrogels Mimicking Cartilage of the Human Body

“…202200283 Clinical repair strategies are primarily focused on auto-or allografting procedures, including osteochondral autograft transfer (OATS) for articular cartilage, and laryngotracheal reconstruction with harvested coastal cartilage. [6,[10][11][12][13] Nonetheless, autografting treatments commonly suffer from donor site morbidity, graft availability, fibrocartilage formation, and graft resorption. [10,[14][15][16][17][18][19][20] Degeneration of intervertebral discs (IVDs) necessitates fusion or replacement employing screws, rods, cages, or artificial discs formed from synthetic materials.…”