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Revision surgery for laryngotracheal stenosis in children : a single center's 44 years experience
ID
Gluvajić, Daša
(
Author
),
ID
Bhate, Janhvi Jayesh
(
Author
),
ID
Sandu, Kishore
(
Author
)
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https://onlinelibrary.wiley.com/doi/10.1002/lary.30632
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Abstract
Objectives: Outcome measures of revision open airway surgery in pediatric laryngotracheal stenosis (LTS) are reported. Methods: Data on 46 pediatric LTS patients undergoing revision open airway surgery were collected retrospectively. The measured outcomes were decannulation rate, time to decannulation, postoperative complications, additional surgery to achieve decannulation, and functional results. Results: The most common revision surgery was partial cricotracheal resection (PCTR) in 21/46, followed by extended PCTR (ePCTR) in 20/46, and laryngotracheal reconstruction (LTR) in 5/46 patients. A 90.7% overall decannulation rate (ODR) and a 74.4% operation-specific decannulation rate (OSDR) were achieved. Delayed decannulation was identified in children aged 5 years or less (p = 0.038) and in patients with previous primary open airway surgery (p = 0.039). Complications were observed in 52.2% of patients. To achieve optimal airway patency, additional open or endoscopic airway surgeries were necessary in 30.4% and 47.7% of patients, respectively. Age 5 years or less (p = 0.034), multiple comorbidities (p = 0.044), revision ePCTR (p = 0.023), and laryngeal stenting (p = 0.018) were risk factors requiring additional open surgery to achieve age-appropriate airway. Failed primary open airway surgery (p = 0.034) and comorbidities (p = 0.044) were risk factors for a higher rate of additional endoscopic surgeries. Postoperatively 63.0% of patients achieved normal breathing, 82.2% were dysphonic and 91.1% were orally fed. Conclusions: In this report, the patient’s age under 5 years, previous primary open airway surgery, medical comorbidities, and laryngeal stenting had a significant negative impact on revision open airway surgery outcomes.
Language:
English
Keywords:
laryngotracheal reconstruction
,
laryngotracheal stenosis
,
revision airway surgery
Work type:
Article
Typology:
1.01 - Original Scientific Article
Organization:
MF - Faculty of Medicine
Publication status:
Published
Publication version:
Version of Record
Year:
2023
Number of pages:
Str. 3200-3207
Numbering:
Vol. 133, iss. 11
PID:
20.500.12556/RUL-153574
UDC:
61
ISSN on article:
1531-4995
DOI:
10.1002/lary.30632
COBISS.SI-ID:
180033539
Publication date in RUL:
16.01.2024
Views:
297
Downloads:
43
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Title:
The laryngoscope
Shortened title:
Laryngoscope
Publisher:
Wiley, The American Laryngological, Rhinological and Otological Society, Inc.
ISSN:
1531-4995
COBISS.SI-ID:
3192596
Licences
License:
CC BY-NC 4.0, Creative Commons Attribution-NonCommercial 4.0 International
Link:
http://creativecommons.org/licenses/by-nc/4.0/
Description:
A creative commons license that bans commercial use, but the users don’t have to license their derivative works on the same terms.
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