Surgical correction of laryngotracheal stenoses in children.

A modified surgical technique according to Rhéti is described: the cricoid and the uppermost tracheal rings are longitudinally dissected ventrally and dorsally. The enlargement of the lumen is stabilized by interposition of a notched piece of costal cartilage into the dissected posterior wall of the cricoid. A total of 63 children with laryngotracheal stenosis have been operated on by this method in Zurich since 1973 and in Munich since 1982. Laryngotracheal plasty is successful in over 80% of small children in whom the procedure is necessary. The voice becomes a little hoarse, but respiration is adequate, as demonstrated by our juvenile patients, some of whom have been decannulated for over 10 years. The earlier opinion that laryngoplasty performed in small children might impair laryngeal growth and result in severe stenoses has been disproved by the results presented. Our experience shows that prognosis is worse in children with tracheal stenosis and associated anomalies, such as paralysis of the vocal cord.