Outcomes of laryngotracheal reconstruction with anterior and posterior costal cartilage grafts in severe pediatric subglottic stenosis or laryngeal web.
10.3760/cma.j.cn115330-20221124-00708
- VernacularTitle:前后肋软骨支架移植喉气管重建术治疗儿童重度声门下狭窄或喉蹼的效果分析
- Author:
Le Tian TAN
1
;
Yi XIE
2
;
Qi LI
1
;
Chao CHEN
1
Author Information
1. Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital of Fudan University, Shanghai 201100, China.
2. Department of General Surgery, PLA Naval medical center, Shanghai 200052, China.
- Publication Type:Journal Article
- MeSH:
Child;
Humans;
Constriction, Pathologic/complications*;
Costal Cartilage;
Hoarseness;
Laryngeal Diseases/complications*;
Laryngostenosis/etiology*;
Retrospective Studies;
Treatment Outcome
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2023;58(7):699-704
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate outcomes of laryngotracheal reconstruction (LTR)with anterior and posterior costal cartilage grafts in severe pediatric subglottic stenosis (SGS) or laryngeal web (LW). Methods: A review of patients with severe subglottic stenosis or laryngeal web between January 2020 and January 2022 was performed. Demographic features including gender, age at diagnosis, age at surgery, etiology, airway support, and other comorbidities were collected preoperatively. Patients were evaluated in surgical site, breathing, swallowing, phonation and complications postoperatively.Descriptive analysis was used in this research. Results: Eight patients were included: six with grade Ⅲ SGS following Cotton-Myer grading scale, and two with type Ⅲ LW following Cohen's classification. All patients underwent LTR with anterior and posterior costal cartilage grafts. Five patients underwent single-stage LTR (ssLTR), and three patients underwent double-stage LTR (dsLTR). Seven out of eight patients were able to successfully extubate or decannulate with normal swallowing function; four patients had mild hoarseness, and three had moderate hoarseness. One patient failed in extubation, and underwent tracheotomy. Conclusions: LTR with anterior and posterior costal cartilage grafts is an effective and safe treatment for severe SGS or LW. Careful preoperative assessment of disease severity and overall medical status will help selection between ssLTR and dsLTR, thereby maximizing patient outcomes for both modalities.
