Revision surgery for laryngotracheal stenosis in children : a single center's 44 years experience

Gluvajić, Daša (avtor), Bhate, Janhvi Jayesh (avtor), Sandu, Kishore (avtor)

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.

• Jezik: Angleški jezik
• Ključne besede: laryngotracheal reconstruction, laryngotracheal stenosis, revision airway surgery
• Vrsta gradiva: Članek v reviji
• Tipologija: 1.01 - Izvirni znanstveni članek
• Organizacija: MF - Medicinska fakulteta
• Status publikacije: Objavljeno
• Različica publikacije: Objavljena publikacija
• Leto izida: 2023
• Št. strani: Str. 3200-3207
• Številčenje: Vol. 133, iss. 11
• PID: 20.500.12556/RUL-153574
• UDK: 61
• ISSN pri članku: 1531-4995
• DOI: 10.1002/lary.30632
• COBISS.SI-ID: 180033539
• Datum objave v RUL: 16.01.2024

Gradivo je del revije

• Naslov: The laryngoscope
• Skrajšan naslov: Laryngoscope
• Založnik: Wiley, The American Laryngological, Rhinological and Otological Society, Inc.
• ISSN: 1531-4995
• COBISS.SI-ID: 3192596

Licence

• Licenca: CC BY-NC 4.0, Creative Commons Priznanje avtorstva-Nekomercialno 4.0 Mednarodna
• Povezava: http://creativecommons.org/licenses/by-nc/4.0/deed.sl
• Opis: Licenca Creative Commons, ki prepoveduje komercialno uporabo, vendar uporabniki ne rabijo upravljati materialnih avtorskih pravic na izpeljanih delih z enako licenco.