Impact of Pre‐operative Multidisciplinary Evaluation on Laryngotracheal Reconstruction Outcomes

2020 ◽  
Author(s):  
Aileen Wertz ◽  
Matthew Ryan ◽  
Ian Jacobs ◽  
Joseph Piccione
Keyword(s):  
Laryngotracheal Reconstruction

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.

scholarly journals Utility of Two-Stage Laryngotracheal Reconstruction in the Management of Subglottic Stenosis in Adults

2009 ◽  
Vol 119 (S3) ◽  
pp. S263-S263
Author(s):  
Nathan A. Deckard ◽  
Justin Yeh ◽  
Michael Criddle ◽  
Robert Stachler ◽  
James Coticchia
Keyword(s):  
Subglottic Stenosis ◽  
Two Stage ◽  
Laryngotracheal Reconstruction

Laryngotracheal Reconstruction Using Microplates in a Porcine Model With Subglottic Stenosis

1996 ◽  
Vol 106 (3) ◽  
pp. 301-305 ◽  
Author(s):  
Mary T. Mitskavich ◽  
Frank L. Rimell ◽  
Andrew M. Shapiro ◽  
J. Christopher Post ◽  
Silloo B. Kapadia
Keyword(s):  
Porcine Model ◽  
Subglottic Stenosis ◽  
Laryngotracheal Reconstruction

A systematic review of simulated laryngotracheal reconstruction animal models

2018 ◽  
Vol 129 (1) ◽  
pp. 235-243 ◽  
Author(s):  
Thomas D. Milner ◽  
Saleh Okhovat ◽  
William A. Clement ◽  
David M. Wynne ◽  
Thushitha Kunanandam
Keyword(s):  
Systematic Review ◽  
Animal Models ◽  
Laryngotracheal Reconstruction

Microbiology of Stents in Laryngotracheal Reconstruction

2004 ◽  
Vol 114 (2) ◽  
pp. 364-367 ◽  
Author(s):  
Payman Simoni ◽  
Brian J. Wiatrak
Keyword(s):  
Laryngotracheal Reconstruction

scholarly journals Topical Mitomycin Application After Laryngotracheal Reconstruction

2001 ◽  
Vol 127 (10) ◽  
pp. 1260 ◽  
Author(s):  
Christopher J. Hartnick ◽  
Benjamin E. J. Hartley ◽  
Peter D. Lacy ◽  
James Liu ◽  
Judy A. Bean ◽  
...  
Keyword(s):  
Laryngotracheal Reconstruction
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