[Tracheal stenosis in children and its operative management (author's transl)].

The problem of tracheal stenosis in children is discussed, with emphasis placed on subglottic disease. The primary etiologies for the stenosis were chronic intubation and emergency tracheostomies following accidents. The operative technique described utilizes vertical division of the trachea and cricoid in the midline. The margins are then stretched laterally and sutured to skin incision lines. Granulations, scar and dislocated cartilage are removed, and the denuded area covered with free mucosal grafts or with pedicle skin flaps. After reestablishing an adequate airway (with use of an acrylic prosthesis for several weeks), the tracheal groove is closed with a composite graft from the auricle. A tracheostomy is left in place an additional 2-3 weeks, while the raw neck area is resurfaced by a transposition flap from adjacent skin. The technique has worked well since 1971 in three children (aged 3, 5 and 7 years), and was also performed successfully on five adult patients.