Editor's Note: This Manuscript was accepted for publication January 7, 2008.
Simple and New Surgical Procedure for Laryngotracheal Separation in Pediatrics†
Article first published online: 2 JAN 2009
Copyright © 2008 The Triological Society
Volume 118, Issue 6, pages 958–961, June 2008
How to Cite
Ninomiya, H., Yasuoka, Y., Inoue, Y., Toyoda, M., Takahashi, K., Miyashita, M. and Furuya, N. (2008), Simple and New Surgical Procedure for Laryngotracheal Separation in Pediatrics. The Laryngoscope, 118: 958–961. doi: 10.1097/MLG.0b013e3181677095
- Issue published online: 2 JAN 2009
- Article first published online: 2 JAN 2009
- Intractable aspiration;
- laryngotracheal separation;
- tracheal closure;
- tracheal flap method
Objectives: In children with severe physical and mental disabilities who repeatedly develop aspiration pneumonia due to intractable aspiration, laryngotracheal separation/tracheoesophageal anastomosis or laryngotracheal separation has been performed in many institutions for the prevention of aspiration, and good results have been reported. However, families sometimes show a marked reluctance to give consent to these surgical techniques because of tracheal transection. A purpose of this study is to evaluate a new surgical procedure for laryngotracheal separation without tracheal transection.
Study Design: Case-series study.
Methods: As a new, simple, less invasive surgical technique for the prevention of aspiration without tracheal transection, we performed tracheal closure (tracheal flap method) in six children. A U-shaped flap of the tracheal anterior wall from the 2nd to the 4th/5th tracheal ring was produced, bent toward the tracheal lumen, and sutured to the tracheal posterior/lateral walls by mattress stitches for tracheal closure. In addition, the closure was covered with a cutaneous U-shaped flap for reinforcement and a permanent tracheal stoma was constructed.
Results: In all six patients, aspiration pneumonia could be prevented without severe complications.
Conclusions: Tracheal closure (tracheal flap method) has effects comparable to those of other surgical techniques for the prevention of aspiration, and may be useful for aspiration prevention in children with severe physical and mental disabilities.