Endoscopic laryngotracheal cleft repair without tracheotomy or intubation.

Details

Serval ID
serval:BIB_4613DF8DF9DA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Endoscopic laryngotracheal cleft repair without tracheotomy or intubation.
Journal
Laryngoscope
Author(s)
Sandu K., Monnier P.
ISSN
0023-852X (Print)
ISSN-L
0023-852X
Publication state
Published
Issued date
2006
Peer-reviewed
Oui
Volume
116
Number
4
Pages
630-634
Language
english
Notes
Publication types: Comparative Study ; Journal Article Publication Status: ppublish
Abstract
OBJECTIVES: The objectives of this study are to present the technique and results of endoscopic repair of laryngotracheoesophageal clefts (LTEC) extending caudally to the cricoid plate into the cervical trachea and to revisit the classification of LTEC.
METHODS: The authors conducted a retrospective case analysis consisting of four infants with complete laryngeal clefts (extending through the cricoid plate in three cases and down into the cervical trachea in one case) treated endoscopically by CO2 laser incision of the mucosa and two-layer endoscopic closure of the cleft without postoperative intubation or tracheotomy.
RESULTS: All four infants resumed spontaneous respiration without support after a mean postoperative period of 3 days with continuous positive airway pressure (CPAP). They accepted oral feeding within 5 postoperative days (range, 3-11 days). No breakdown of endoscopic repair was encountered. After a mean follow up of 48 months (range, 3 mos to 7 y), all children have a good voice, have no sign of residual aspiration, but experience a slight exertional dyspnea.
CONCLUSION: This limited experience on the endoscopic repair of extrathoracic LTEC shows that a minimally invasive approach sparing the need for postoperative intubation or tracheotomy is feasible and safe if modern technology (ultrapulse CO2 laser, endoscopic suturing, and postoperative use of CPAP in the intensive care unit) is available.
Keywords
Abnormalities, Multiple/surgery, Endoscopy/methods, Esophagus/abnormalities, Esophagus/surgery, Follow-Up Studies, Humans, Infant, Intubation, Intratracheal, Larynx/abnormalities, Larynx/surgery, Retrospective Studies, Time Factors, Trachea/abnormalities, Trachea/surgery, Tracheotomy, Treatment Outcome
Pubmed
Web of science
Create date
16/06/2015 12:12
Last modification date
20/08/2019 14:51
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