Slide tracheoplasty for congenital funnel-shaped tracheal stenosis

Tsang, Victor; Murday, Andrew J.; Gillbe, Charles; Goldstraw, Peter

doi:10.1016/0003-4975(89)90777-7

Cited by 279 publications

(153 citation statements)

References 9 publications

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“…It was originally developed to treat long- segment congenital stenosis and first described in 1989 by Tsang and Goldstraw (41). The basic principle of tracheoplasty is a doubling of the stenotic tracheal lumen by dividing the stenotic airway in the middle of the stenosis and sliding the two newly formed segments into each other ( Figure 5).…”

Section: Slide Tracheoplastymentioning

confidence: 99%

Pediatric airway surgery

Höetzenecker¹,

Schweiger²,

Denk-Linnert³

et al. 2017

J. Thorac. Dis.

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The pediatric airway-general implicationsThe pediatric airway has several distinct features compared to the adult airway. First, dimensions are much smaller. This is particularly important with regards to the subglottis. The inner-diameter of the subglottis of a newborn usually measures between 3 and 4 mm (1). A pathological process in this area, leading to a circular lumen reduction of only one millimeter, can result in a life-threatening near-occlusion.A second feature of the pediatric airway is that the cartilaginous parts are still malleable and cannot provide the same stability as an adult airway skeleton. This can become a problem after airway reconstructions and usually results in the need of prolonged postoperative stentings to support a laryngotracheal repair. The lack of stability of the trachea in a newborn (compared to an adult) also makes it more prone to develop tracheomalacia. Vessel malformations (vascular rings) can apply pressure to the airway, causing dynamic collapse and making surgical correction often inevitable (2).On the other hand, the flexibility of the pediatric trachea facilitates long-segmental resections. In children, up to 50 percent of the airway length can be resected without extensive tension on the anastomosis (3).With regards to the functional aspects of the pediatric larynx, the anatomical relationship between the glottis and the hyoid is also a unique feature. The thyrohyoid membrane is shorter than in adults and the thyroid notch usually projects behind the hyoid. This high location of the larynx raises the tip of the epiglottis behind the uvula, thus, permitting simultaneous breathing and swallowing (4). Consequently, swallowing problems are rare in children and the pediatric larynx can handle even profound changes in its configuration. In fact, extensive laryngotracheal resections and reconstructions are possible without risking severe postoperative swallowing problems. Diseases of the pediatric airway Laryngotracheal stenosisAirway injury secondary to traumatic intubation remains the most common cause of laryngotracheal stenosis, accounting for about 90% of all pediatric acquired airway stenosis (5). The majority of intubation-related injuries are due to the comorbidities. This comprehensive review should give an overview on most common airway problems in neonates and children as well as available surgical techniques.

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Section: Slide Tracheoplastymentioning

confidence: 99%

Pediatric airway surgery

Höetzenecker¹,

Schweiger²,

Denk-Linnert³

et al. 2017

J. Thorac. Dis.

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“…Several operative techniques for treating CTS have been described, including resection with end-to-end anastomosis, 7 rib cartilage graft tracheoplasty, 8,9 pericardial patch tracheoplasty, 5,7,10,11 and slide tracheoplasty. 4,5,7,[12][13][14][15][16][17] Additionally, the use of endoscopic stenting as the primary treatment of CTS was recently reported. 18 The purpose of this review is to (1) provide a comprehensive overview of the pathology, presentation, and treatment indications for CTS, (2) describe the available therapeutic options and their outcomes, and (3) outline a contemporary management approach for treating patients with CTS.…”

mentioning

confidence: 99%

Management of Congenital Tracheal Stenosis

Hofferberth¹,

Watters

Rahbar

et al. 2015

PEDIATRICS

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Congenital tracheal stenosis (CTS) is a serious and rare condition. In most cases, stenotic lesions are composed of complete tracheal rings of cartilage. The severity of symptoms correlates with the length of affected trachea, the presence of concomitant respiratory conditions, degree of luminal narrowing, and any bronchial involvement. Critically, CTS is a disorder that can lead to life-threatening respiratory insufficiency in children. Thus, it is a clinical entity that demands timely diagnosis and treatment. This review will firstly discuss the anatomy and pathophysiology of CTS and outline the various clinical presentations associated with the disorder. In addition, methods of diagnosis and treatment strategies will be reviewed, with a focus on contemporary surgical techniques. Finally, postoperative care of patients with CTS will be reviewed, and a contemporary multidisciplinary management approach will be presented.

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“…Slide tracheoplasty was originally described by Tsang et al (32) and popularized by both Grillo et al (7) and by our team at Cincinnati Children's Hospital (6). This operation overlaps stenotic segments of the trachea, shortening it but doubling the diameter of the stenotic area.…”

Section: Slide Tracheoplastymentioning

confidence: 99%