Pediatric airway reconstruction with a prefabricated auricular cartilage and radial forearm free flap.

Prefabricated composite free flaps for complex airway reconstruction have been described for an adult series at our institution. We extended this approach to a pediatric patient with lifelong subglottic stenosis who had failed previous open airway reconstructions. A staged procedure was utilized in which a composite graft was created using conchal cartilages and a radial forearm free flap. This reconstruction improved the patency of her airway and decreased her dependency on intermittent airway dilations. Airway reconstruction with prefabricated conchal cartilage composite free flaps may be used as a salvage procedure for complex pediatric airway reconstruction when other methods have failed.

Cystic hygroma co-existing with congenital subglottic stenosis.

Respiratory distress is one of the commonest cause of admission into a Neonatal Intensive Care Unit, be it surgical or medical in nature. Adequate and prompt resuscitation as well as intubation can be life saving. Emergency or early tracheostomy may be necessary if airway intervention is needed. The authors present the case of a term neonate who was born with a large cervical cystic hygroma causing compression of the airway, together with a concurrent grade III subglottic stenosis, in respiratory distress within few minutes of life. Nine months post tracheostomy and sclero-therapy treatment twice, the child shows marked improvement. The succesful management of this unusual case of severe extrinsic compression with concurrent internal airway obstruction is presented.