PEDIATRIC LARYNGOTRACHEAL RECONSTRUCTION WITH CARTILAGE GRAFTS AND ENDOTRACHEAL-TUBE STENTING - THE SINGLE-STAGE APPROACH

Laryngotracheal reconstruction (LTR) comprises five stages: 1, charact erization of the stenosis; 2, expansion of the lumen; 3, stabilization of the enlarged lumen framework; 4, healing of the surgical site; and 5, decannulation. Single-stage LTR (SS-LTR) combines and compresses s tages 3 through 5 (stabilization, healing, and decannulation) into a b rief period of postoperative intubation.At Children's Hospital Medical Center in Cincinnati, Ohio, from January 1987 to December 1993, 116 r econstructive procedures were performed by using postoperative intubat ion. Nine were tracheoplasty or stoma-revision procedures in isolation , leaving 107 SS-LTR procedures that included the laryngotracheal comp lex. The use of SS-LTR has increased to 30% of LTRs performed in 1993. Data are presented on the success of SS-LTR as measured by the number of decannulations and extubations achieved.