Single-stage laryngotracheal reconstruction in children: A review of 200 cases

OBJECTIVE: We reviewed our experience with pediatric single-stage laryngotr acheal reconstruction (SSLTR) to identify factors that affect postoperative outcomes, including the need for reintubation and tracheostomy. STUDY DESIGN: Retrospective chart review was done. RESULTS: In total, 190 children underwent 200 SSLTRs; 29% were reintubated, and 15% required postoperative tracheostomy, Currently, 96% are decannulat ed. The use of anterior and posterior costal cartilage grafting, age less t han 4 years, sedation for more than 48 hours, a leak pressure around the en dotracheal tube at greater than 20 cm H2O, and moderate/severe tracheomalac ia significantly increased the rate of reintubation, The duration of stenti ng did not affect outcomes. Children with anterior and posterior grafts and those with moderate or severe tracheomalacia were more likely to need a po stoperative tracheostomy. CONCLUSION: SSLTR can be effective for the treatment of pediatric laryngotr acheal stenosis. Diligent preoperative assessment of the patient and the pa tient's airway and close postoperative care are important to the success of this operation.