EXPERIENCE WITH ONE-STAGE LARYNGOTRACHEAL RECONSTRUCTION

Eight patients (ages 10 months to 5 years) underwent laryngotracheal r econstruction (LTR) without intraluminal stenting or tracheostomy. All patients had moderate to severe acquired or congenital subglottic ste nosis. Six patients were tracheostomy-dependent prior to reconstructio n. The other two children were intubated and would have required trach eostomy for airway control. LTR and decannulation/extubation were acco mplished as a one-stage procedure. Autologous rib cartilage was used ( anterior graft only -6 patients, anterior and posterior graft - 3 pati ents) and patients were intubated for 7-10 days. Pulmonary complicatio ns from the week-long intubation and intensive care unit stay were com mon, but easily managed. Seven of eight patients were successfully dec annulated/extubated.