Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Italy.
Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Italy.
Int J Pediatr Otorhinolaryngol. 2022 Jul;158:111164. doi: 10.1016/j.ijporl.2022.111164. Epub 2022 Apr 26.
The aim of this study is to report our experience with double-stage laryngotracheal reconstruction with anterior or antero-posterior cartilage grafting in the management of acquired laryngotracheal stenosis in children. Patients were treated by the same surgeon at the UMC National Research Center for Maternal and Child Health of Astana (Kazakhstan), and Sfendiyarov Kazakh National Medical University, Almaty (Kazakhstan).
From November 2011 to September 2019, 9 children underwent surgery for grade III and IV laryngotracheal stenosis according to the European Laryngological Society classification (mean age of 6 years, range of 2-12 years).
Six patients underwent double-stage laryngotracheal reconstruction with anterior and posterior cartilage graft, and 3 patients underwent double-stage laryngotracheal reconstruction with single anterior cartilage graft. In all patients, a T-tube was used to stabilize the airway (mean time of 5.8 months, range of 5-9 months). One patient required additional dilation with bougies to obtain a viable laryngotracheal diameter. No postoperative complications were observed. One patient experienced recurrence of the stenosis 5 months after double-stage laryngotracheal reconstruction with double anterior and posterior cartilage grafts and is waiting for revision surgery. After a mean follow-up of 14 months (range of 4-36 months), 8 patients are tracheostomy-free, and all patients are feeding tube-free.
Double-stage laryngotracheal reconstruction with a single or double cartilage grafting represents a safe and effective option in the management of complete or severe laryngotracheal stenosis.
本研究旨在报告我们在哈萨克斯坦阿斯塔纳国立母婴健康研究中心（UMC）和阿拉木图 Sfendiyarov 哈萨克国立医科大学，采用前或前-后软骨移植的两阶段喉气管重建术治疗儿童获得性喉气管狭窄的经验。
自 2011 年 11 月至 2019 年 9 月，根据欧洲喉科学会分类（平均年龄 6 岁，范围 2-12 岁），9 例儿童因 3 或 4 级喉气管狭窄接受手术治疗。
6 例患者行前-后软骨移植两阶段喉气管重建术，3 例患者行单前软骨移植两阶段喉气管重建术。所有患者均使用 T 型管稳定气道（平均时间 5.8 个月，范围 5-9 个月）。1 例患者需要用探条进行额外扩张以获得可存活的喉气管直径。无术后并发症。1 例患者在接受前-后双软骨移植两阶段喉气管重建术后 5 个月时出现狭窄复发，正在等待再次手术。平均随访 14 个月（4-36 个月）后，8 例患者无需行气管造口术，所有患者均无需经饲管喂养。
采用单或双软骨移植的两阶段喉气管重建术是治疗完全性或严重喉气管狭窄的安全有效方法。
