LARYNGOTRACHEAL RECONSTRUCTION WITHOUT STENTING

Many surgical procedures, including laryngotracheal expansion with or without grafting, have been suggested for repairing laryngotracheal st enosis in children, and although a variety of stents have been describ ed, the practice of prolonged stenting continues to diminish. We descr ibe 21 pediatric patients with moderate-to-severe subglottic or trache al stenosis who had laryngotracheal reconstructions with anterior rib cartilage grafts without stenting or intubation. The patients were bet ween 6 months and 7 years of age at the time of surgery. All patients were extubated in the operating room after the procedure was terminate d. One patient required reintubation in the intensive care unit for 48 hours after surgery, and another patient required a tracheotomy. Woun d infection occurred in one patient. Most patients were discharged to their homes 3 to 5 days after surgery. We report the indications, tech nique, results, and complications of laryngotracheal reconstruction us ing a rib graft without stenting.