The history of pediatric airway reconstruction

2010 ◽  
Vol 120 (4) ◽  
pp. 815-820 ◽  
Author(s):  
Daniel Santos ◽  
Ron Mitchell
Keyword(s):  
Pediatric Airway ◽  
Airway Reconstruction ◽  
History Of

Tracheocutaneous Fistula After Pediatric Open Airway Reconstruction

2021 ◽  
pp. 000348942098742
Author(s):  
Stephen R. Chorney ◽  
Joanne Stow ◽  
Luv R. Javia ◽  
Karen B. Zur ◽  
Ian N. Jacobs ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Case Series ◽  
Primary Objective ◽  
Multivariable Logistic Regression Analysis ◽  
Pediatric Airway ◽  
Surgical Closure ◽  
Laryngotracheal Reconstruction ◽  
Airway Reconstruction ◽  
Tracheocutaneous Fistula

Objectives: Tracheocutaneous fistula (TCF) is a common occurrence after pediatric tracheostomy decannulation. However, the persistence of TCF after staged reconstruction of the pediatric airway is not well-described. The primary objective was to determine the rate of persistent TCF after successful decannulation in children with staged open airway reconstruction. Methods: A case series with chart review of children who underwent decannulation after double-stage laryngotracheal reconstruction between 2017 and 2019. Results: A total of 26 children were included. The most common open airway procedure was anterior and posterior costal cartilage grafting (84.6%, 22/26). Median age at decannulation was 3.4 years (IQR: 2.8-4.3) and occurred 7.0 months (IQR: 4.3-10.4) after airway reconstruction. TCF persisted in 84.6% (22/26) of children while 15.4% (4/26) of stomas closed spontaneously. All closures were identified by the one-month follow-up visit. There was no difference in age at tracheostomy ( P = .86), age at decannulation ( P = .97), duration of tracheostomy ( P = .43), or gestational age ( P = .23) between stomas that persisted or closed. Median diameter of stent used at reconstruction was larger in TCFs that persisted (7.0 mm vs 6.5 mm, P = .03). Tracheostomy tube diameter ( P = .02) and stent size ( P < .01) correlated with persistence of TCF on multivariable logistic regression analysis. There were 16 surgical closure procedures, which occurred at a median of 14.4 months (IQR: 11.4-15.4) after decannulation. Techniques included 56.3% (9/16) by primary closure, 18.8% (3/16) by secondary intention and 25% (4/16) by cartilage tracheoplasty. The overall success of closure was 93.8% (15/16) at latest follow-up. Conclusions: Persistent TCF occurs in 85% of children who are successfully decannulated after staged open airway reconstruction. Spontaneous closure could be identified by 1 month after decannulation and was more likely when smaller stents and tracheostomy tubes were utilized. Surgeons should counsel families on the frequency of TCF and the potential for additional procedures needed for closure.

Vocal Fold Injection Augmentation for Post-Airway Reconstruction Dysphonia: A Case Series

2021 ◽  
pp. 000348942110125
Author(s):  
Mathieu Bergeron ◽  
John Paul Giliberto ◽  
Meredith E. Tabangin ◽  
Alessandro de Alarcon
Keyword(s):  
Vocal Fold ◽  
Care Center ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Pediatric Care ◽  
Voice Perception ◽  
Perceptual Evaluation ◽  
Airway Reconstruction ◽  
Vocal Fold Injection ◽  
History Of

Objectives: Post airway reconstruction dysphonia (PARD) is common and has a significant effect on the quality of life of patients. Vocal fold injection augmentation (VFIA) is one treatment that can be used to improve glottic insufficiency in some patients. The goal of this study was to characterize the use and outcomes of VFIA for PARD. Methods: Retrospective chart review from January 2007 to July 2018 at a tertiary pediatric care center. Consecutive patients with PARD who underwent VFIA, who had a preoperative voice evaluation and a follow-up evaluation within 3 months after VFIA (fat, carboxymethylcellulose gel, hyaluronic acid). Results: Thirty-four patients (20 female) underwent VFIA. The mean age at the time of the injection was 13.6 years (SD 6.1). Twenty patients (58.8%) had a history of prematurity and a mean of 1.8 open airway surgeries. After injection, 29/34 patients (85.3%) noted a subjective voice improvement. The baseline Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) overall severity score decreased by a mean of 5.7 (SD = 19.6) points, P = .12. Total pediatric Voice Handicap Index (pVHI) improved by 6.0 (SD = 19.5) points, from 57.4 (SD = 20.0) to 51.4 (SD = 17.2), P = .09. Functional pVHI subscore demonstrated a significant improvement, with a decrease of 3.4 (SD = 7.3) points, P = .02. All procedures were performed as an overnight observation and no complication occurred. Conclusion: Patients with PARD represent a complex subset of patients. VFIA is a straightforward intervention that may improve voice perception. Many patients reported subjective improvement despite minimal objective measurement. Further work is warranted to elucidate the role of injection in management of PARD

Stenting in pediatric airway reconstruction

2012 ◽  
Vol 122 (S4) ◽  
pp. S97-S98 ◽  
Author(s):  
Diego Preciado
Keyword(s):  
Pediatric Airway ◽  
Airway Reconstruction

Pediatric Airway Reconstruction at Great Ormond Street: A Ten-Year Review

1992 ◽  
Vol 101 (6) ◽  
pp. 465-468 ◽  
Author(s):  
James W. Ochi ◽  
John N. G. Evans ◽  
C. Martin Bailey
Keyword(s):  
Costal Cartilage ◽  
Laryngotracheal Stenosis ◽  
Pediatric Airway ◽  
Airway Reconstruction ◽  
Cartilage Grafting

One hundred eight consecutive patients with pediatric laryngotracheal stenosis requiring airway reconstruction over a 10-year period were reviewed. One hundred forty-nine operations consisting of 75 laryngotracheoplasties and 74 laryngotracheal reconstructions with costal cartilage grafting were performed. The Cotton grading scheme of preoperative stenosis was useful in predicting likelihood of decannulation. In all, 90 patients (83%) were decannulated.

HISTORY OF PEDIATRIC AIRWAY MANAGEMENT

2000 ◽  
Vol 33 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Gregory C. Allen ◽  
Sylvan E. Stool
Keyword(s):  
Airway Management ◽  
Pediatric Airway ◽  
History Of

SP364 – Feeding and growth after pediatric airway reconstruction

2009 ◽  
Vol 141 (3) ◽  
pp. P206-P206
Author(s):  
Steven Michael Andreoli ◽  
David R. White ◽  
Shaun A. Nguyen
Keyword(s):  
Pediatric Airway ◽  
Airway Reconstruction

A Sustainable and Scalable Multidisciplinary Airway Teaching Mission: The Operation Airway 10-Year Experience

2020 ◽  
Vol 163 (5) ◽  
pp. 971-978
Author(s):  
Asitha D. L. Jayawardena ◽  
Zelda J. Ghersin ◽  
Marcos Mirambeaux ◽  
Jose A. Bonilla ◽  
Ernesto Quiñones ◽  
...  
Keyword(s):  
Dominican Republic ◽  
El Salvador ◽  
Multidisciplinary Team ◽  
Surgical Outcomes ◽  
Demographic Data ◽  
Operative Procedure ◽  
Case Series ◽  
The United States ◽  
Pediatric Airway ◽  
Airway Reconstruction

Objective To address whether a multidisciplinary team of pediatric otolaryngologists, anesthesiologists, pediatric intensivists, speech-language pathologists, and nurses can achieve safe and sustainable surgical outcomes in low-resourced settings when conducting a pediatric airway surgical teaching mission that features a program of progressive autonomy. Study Design Consecutive case series with chart review. Setting This study reviews 14 consecutive missions from 2010 to 2019 in Ecuador, El Salvador, and the Dominican Republic. Methods Demographic data, diagnostic and operative details, and operative outcomes were collected. A country’s program met graduation criteria if its multidisciplinary team developed the ability to autonomously manage the preoperative huddle, operating room discussion and setup, operative procedure, and postoperative multidisciplinary pediatric intensive care unit and floor care decision making. This was assessed by direct observation and assessment of surgical outcomes. Results A total of 135 procedures were performed on 90 patients in Ecuador (n = 24), the Dominican Republic (n = 51), and El Salvador (n = 39). Five patients required transport to the United States to receive quaternary-level care. Thirty-six laryngotracheal reconstructions were completed: 6 single-stage, 12 one-and-a-half-stage, and 18 double-stage cases. We achieved a decannulation rate of 82%. Two programs (Ecuador and the Dominican Republic) met graduation criteria and have become self-sufficient. No mortalities were recorded. Conclusion This is the largest longitudinal description of an airway reconstruction teaching mission in low- and middle-income countries. Airway reconstruction can be safe and effective in low-resourced settings with a thoughtful multidisciplinary team led by local champions.

Dexmedetomidine Use in Pediatric Airway Reconstruction

2010 ◽  
Vol 143 (2_suppl) ◽  
pp. P113-P114
Author(s):  
Amanda Silver ◽  
Natan Noviski ◽  
Christopher Hartnick ◽  
Phoebe Yager
Keyword(s):  
Pediatric Airway ◽  
Airway Reconstruction

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

2020 ◽  
Vol 86 (2) ◽  
pp. 157-164 ◽  
Author(s):  
Rebecca Maunsell ◽  
Nayara Soares Lacerda ◽  
Luciahelena Prata ◽  
Marcelo Brandão
Keyword(s):  
Pediatric Airway ◽  
Airway Reconstruction
Sign in / Sign up

Export Citation Format

Share Document