Objective. This review of 54 infants and children with airway obstruct
ion who were treated surgically emphasizes the importance of the surgi
cal indications with respect to various anomalies causing airway obstr
uction, and the surgical approach to their management. Patients. There
were 4 etiologic groups of airway obstruction. Group A comprised 12 i
nfants with subglottic stenosis; Group B-20 infants with tracheomalaci
a; 21 patients (Group C) with anatomic narrowing of the trachea; and 1
infant (Group D) with laceration of a main bronchus. Methods. The sur
gical procedures performed included anterior laryngotracheal decompres
sion in 12 infants, aortopexy in 19; 1 pulmonary arteriopexy; tracheal
stenting with an autologous rib graft in 3 and with Marlex mesh in 1.
Tracheal widening, using a free tibia autologous graft, was performed
in 3 patients; trans-bronchoscopic excision in 12; anterior tracheal
wedge resection in 4, and segmental tracheal resection and anastomosis
in 1 patient. The lacerated bt bronchus was repaired with fine Dexon
sutures. Results. There were no operative deaths. With respect to the
original indications for surgery, there were 3 failures-2 in Group A a
nd 1 in Group C. Two patients died from causes unrelated to the proced
ures-one 10 days postoperatively, and the other 3 months after surgery
. Conclusions. The surgical approach to tracheal obstruction in infant
s and children offers effective treatment, with no operative mortality
, a low complication rate, and good long term survival.