Comparison of hybrid laryngotracheal reconstruction to traditional single- and double-stage laryngotracheal reconstruction.
Otolaryngol Head Neck Surg
; 152(3): 524-9, 2015 Mar.
Article
em En
| MEDLINE
| ID: mdl-25573683
ABSTRACT
OBJECTIVES:
(1) To describe outcomes from and modifications to the hybrid laryngotracheal reconstruction (LTR) technique and (2) to compare this technique to traditional single- and double-stage LTR (ssLTR/dsLTR). STUDYDESIGN:
Chart review with case series.SETTING:
Tertiary care otolaryngology specialty hospital.SUBJECTS:
All patients under 18 years of age who underwent LTR by a single surgeon from July 1, 2009, to December 31, 2013.METHODS:
Charts were assessed for age, gender, etiology of stenosis, type of reconstruction, comorbidities, length of stay, complications, and tracheostomy status. Analysis was performed using Kruskal-Wallis and Wilcoxon rank sum analysis.RESULTS:
Forty-four patients were identified, with 13 hybrid LTRs, 27 ssLTRs, and 4 dsLTRs. Of the hybrid LTRs, an overall decannulation rate of 76.9% was noted, comparable to those for dsLTR. The hybrid LTR technique offered a significantly shorter period of narcotic use when compared to ssLTR (median 15 vs 21 days, P<.01). No patients in the hybrid LTR group developed supraglottic granulation tissue. There was no statistically significant difference in median length of stay for ssLTRs, dsLTRs, and hybrid LTRs (P=.38).CONCLUSION:
The hybrid LTR technique is well tolerated and useful in patients of all ages. Narcotics can be weaned more quickly due to the presence of a secure airway at all times via the existing tracheostomy. Use of a long stent prevents formation of granulation tissue that may be seen with a suprastomal stent. This technique should be considered in patients with high-grade stenosis with a preexisting tracheostomy.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Traqueia
/
Estenose Traqueal
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Traqueostomia
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Laringoestenose
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Laringoplastia
/
Laringe
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Child, preschool
/
Female
/
Humans
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Infant
/
Male
Idioma:
En
Revista:
Otolaryngol Head Neck Surg
Assunto da revista:
OTORRINOLARINGOLOGIA
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Estados Unidos