Laryngotracheal reconstruction for pediatric glotto-subglottic stenosis.

Détails

ID Serval
serval:BIB_224DBCEE2A91
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Laryngotracheal reconstruction for pediatric glotto-subglottic stenosis.
Périodique
International Journal of Pediatric Otorhinolaryngology
Auteur⸱e⸱s
Yamamoto K., Monnier P., Holtz F., Jaquet Y.
ISSN
1872-8464 (Electronic)
ISSN-L
0165-5876
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
78
Numéro
9
Pages
1476-1479
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish
Résumé
BACKGROUND: The management of pediatric laryngotracheal stenosis (LTS) can be challenging, and laryngotracheal reconstruction (LTR) with cartilage interposition grafting remains the mainstay of surgical treatment for pediatric LTS in most experienced centers. The purpose of this study was to report the results of this procedure in a center where primary cricotracheal resection is frequently performed.
METHODS: A retrospective chart review was performed on 45 patients who underwent LTR in our hospital between October 1997 and July 2012. Demographic characteristics and information on the preoperative status, stenosis, and operation were collected. Primary outcomes were measured as overall (ODR) and operation-specific (OSDR) decannulation rates and secondary outcomes as morbidity, mortality, and postoperative functional results.
RESULTS: ODR and OSDR were 86.7% (39/45) and 66.7% (30/45), respectively. Re-stenosis was observed in 11/45 (24%) patients, all of whom were endoscopically or surgically treated. Revision surgery was performed in 10 patients, 6 for re-stenosis and 2 for peristomial tracheomalacia. Two children died of mucous obstruction of tracheostomy tube at 3 and 6 months postoperatively (4.4%). Respiratory, voice, and swallowing functions were excellent or good in 86, 75, and 84% of patients, respectively.
CONCLUSIONS: LTR for pediatric LTS has high decannulation rates with acceptable morbidity and mortality in selected patients. Most LTR procedures were double-stage for lower grade subglottic stenoses associated with glottic involvement that required stenting. Careful preoperative evaluation and adequate surgical indications are extremely important to achieve high decannulation rates.
Pubmed
Web of science
Création de la notice
19/09/2014 17:38
Dernière modification de la notice
20/08/2019 12:59
Données d'usage