The surgical treatment of acquired subglottic stenosis in children with double-stage laryngotracheal reconstruction
Carta F. Piras N. Mariani C. Marrosu V. Tatti M. Chuchueva N. Bekpanov A. Medeulova A.R. Shetty S.A. Puxeddu R.
July 2022Elsevier Ireland Ltd
International Journal of Pediatric Otorhinolaryngology
2022#158
Objectives: The aim of this study is to report our experience with double-stage laryngotracheal reconstruction with anterior or antero-posterior cartilage grafting in the management of acquired laryngotracheal stenosis in children. Patients were treated by the same surgeon at the UMC National Research Center for Maternal and Child Health of Astana (Kazakhstan), and Sfendiyarov Kazakh National Medical University, Almaty (Kazakhstan). Methods: From November 2011 to September 2019, 9 children underwent surgery for grade III and IV laryngotracheal stenosis according to the European Laryngological Society classification (mean age of 6 years, range of 2–12 years). Results: Six patients underwent double-stage laryngotracheal reconstruction with anterior and posterior cartilage graft, and 3 patients underwent double-stage laryngotracheal reconstruction with single anterior cartilage graft. In all patients, a T-tube was used to stabilize the airway (mean time of 5.8 months, range of 5–9 months). One patient required additional dilation with bougies to obtain a viable laryngotracheal diameter. No postoperative complications were observed. One patient experienced recurrence of the stenosis 5 months after double-stage laryngotracheal reconstruction with double anterior and posterior cartilage grafts and is waiting for revision surgery. After a mean follow-up of 14 months (range of 4–36 months), 8 patients are tracheostomy-free, and all patients are feeding tube-free. Conclusions: Double-stage laryngotracheal reconstruction with a single or double cartilage grafting represents a safe and effective option in the management of complete or severe laryngotracheal stenosis.
Airway , Cartilage graft , Pediatric , Reconstruction , Subglottic stenosis
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Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Italy
I. M. Sechenov First Moscow State Medical University, Moscow, Russian Federation, Central State Medical Academy of Department for Presidential Affairs of the Russian Federation, Moscow, Russian Federation
UMC National Research Center for Mother and Child Health, Astana, Kazakhstan
Asfendiyarov Kazakh National Medical University, Kazakhstan
Guys and st ThomasTrust, UK, United Kingdom
Unit of Otorhinolaryngology
I. M. Sechenov First Moscow State Medical University
UMC National Research Center for Mother and Child Health
Asfendiyarov Kazakh National Medical University
Guys and st ThomasTrust
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