The authors have no funding, financial relationships, or conflicts of interest to disclose.
Article first published online: 29 FEB 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 4, pages 920–924, April 2012
How to Cite
Javia, L. R. and Zur, K. B. (2012), Laryngotracheal reconstruction with resorbable microplate buttressing. The Laryngoscope, 122: 920–924. doi: 10.1002/lary.23224
Poster presentation at the American Society of Pediatric Otolaryngology, Combined Otolaryngology Spring Meetings, Las Vegas, Nevada, U.S.A., April 30, 2010. Awarded second place prize: Case Study/Series Poster.
- Issue published online: 20 MAR 2012
- Article first published online: 29 FEB 2012
- Manuscript Accepted: 5 JAN 2012
- Manuscript Revised: 16 DEC 2011
- Manuscript Received: 17 AUG 2011
- Laryngotracheal reconstruction;
- absorbable microplates;
- subglottic stenosis
In patients undergoing laryngotracheal reconstruction (LTR), malacic segments of trachea can pose challenges to successful reconstruction. Malacic segments may inadequately support cartilage grafts used in augmentation surgery, sometimes requiring cricotracheal or tracheal resections. We describe a novel technique of LTR with resorbable microplate buttressing of malacic lateral tracheal segments.
Retrospective case series.
Review of technique, treatment outcomes, and complications of seven children with subglottic stenosis and tracheomalacia requiring a microplate-augmented LTR technique.
Seven infants ranging from 26 months to 9 years of age successfully underwent LTR for subglottic stenosis. Six children had a grade III subglottic stenosis. The seventh child had grade II subglottic stenosis, bilateral vocal fold paralysis, an elliptical cricoid, and an obstructing giant suprastomal fibroma. Five children underwent a double-stage LTR with resorbable microplates sutured bilaterally to support severely malacic lateral tracheal segments. A cricotracheal resection would not have been feasible in one child due to the resection length and inadequate tracheal mobilization. Two children underwent a single-stage LTR with unilateral application of a microplate. Six children were decannulated within 3 months and continue without airway symptoms or complications. One child, who is just over 2 months from reconstructive surgery, is being setup for decannulation. No complications were encountered.
LTR with resorbable microplate buttressing of malacic lateral tracheal segments is technically feasible, safe, and can avoid more extensive surgery requiring tracheal resection. Further experience may support the use of this technique in challenging airway reconstructions. Laryngoscope, 2012