RESULTS OF A MODIFIED RETHIS TECHNIQUE IN CHILDREN

Background: Laminotomy as described by Rethi has proved useful in the treatment of laryngotracheal stenoses. Using this technique in childre n poses the question as to whether it interferes with the growth of th e larynx and trachea. The aim of our study was to verify the influence of this operative procedure on the structure and function of the rest ored airway. Patients: Fifteen children between the ages of 2 and 16 w ith severe laryngotracheal stenoses (Cotton Grade III and IV) underwen t reconstruction with interposition of a piece of costal cartilage in the posterior cricoid plate. Indications for this procedure included t he presence of severe circumferential subglottic stenosis in combinati on with stenosis of the posterior glottis (8 children) and complete at resia (4 children). Results: In endoscopic follow-up examinations (2-1 2 years follow-up), complete epithelization with light stenosis in the subglottis was demonstrated in all cases. Airway ventilation tests sh owed a slight or moderate central obstruction in nearly all cases. No disturbance of growth of the larynx was noted. Conclusions: This techn ique is a safe and successful method for repairing severe subglottic s tenoses in children. Although there are some structural and functional problems during the long term follow-up, this is not considered a sig nificant disadvantage.