Experience with one-stage laryngotracheal reconstruction.

Eight patients (ages 10 months to 5 years) underwent laryngotracheal reconstruction (LTR) without intraluminal stenting or tracheostomy. All patients had moderate to severe acquired or congenital subglottic stenosis. Six patients were tracheostomy-dependent prior to reconstruction. The other two children were intubated and would have required tracheostomy for airway control. LTR and decannulation/extubation were accomplished as a one-stage procedure. Autologous rib cartilage was used (anterior graft only--6 patients, anterior and posterior graft--3 patients) and patients were intubated for 7-10 days. Pulmonary complications from the week-long intubation and intensive care unit stay were common, but easily managed. Seven of eight patients were successfully decannulated/extubated.