LARYNGOTRACHEAL RECONSTRUCTION USING MICROPLATES IN A PORCINE MODEL WITH SUBGLOTTIC STENOSIS

Current techniques of laryngotracheal reconstruction require a choice between prolonged stenting (conventional technique) or short-term sten ting with maintenance of sedation and paralysis until the airway has s tabilized (single-stage laryngotracheal reconstruction). An alternativ e method is proposed using microplates to provide immediate airway sta bilization without stenting. This study was designed to evaluate the l ong-term effects of microplate repair of stenosis of the subglottis an d trachea on the growing larynx, Subglottic stenosis was produced in p iglets using a transoral endoscopic technique. Eight animals underwent repair of the stenosis using an anterior cricoid split with microplat e distraction and stabilization of the cricoid cartilage and first tra cheal ring. The distraction was maintained and airway growth continued for the duration of this study. However, with growth of the larynx th e plates migrated away from their original position. In 50% of the ani mals followed up for 90 days the plates migrated into the airway lumen . This study suggests that rigid distraction of the stenotic airway wi th microplates is a viable alternative to more traditional methods of repair. However, plate removal at some interval after surgery is requi red in the growing larynx in order to prevent migration of the plate i nto the airway.