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

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

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

Record is a part of a journal

• 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.