Airway and Swallowing Outcomes Following Laryngotracheoplasty With Posterior Grafting in Children.
Child
Child, Preschool
Deglutition Disorders
/ etiology
Female
Follow-Up Studies
Gastrostomy
/ statistics & numerical data
Humans
Infant
Laryngoplasty
/ adverse effects
Laryngostenosis
/ complications
Male
Retrospective Studies
Trachea
/ surgery
Treatment Outcome
Vocal Cord Paralysis
/ complications
Pediatric
airway
decannulation
laryngotracheoplasty
posterior graft
swallowing
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
revised:
01
04
2021
received:
11
01
2021
accepted:
28
04
2021
pubmed:
26
5
2021
medline:
25
11
2021
entrez:
25
5
2021
Statut:
ppublish
Résumé
Evaluate swallowing and airway outcomes following laryngotracheoplasty with posterior grafting (LTP PCCG). Retrospective review of pediatric patients undergoing LTP PCCG from 2016 to 2019 at a tertiary care pediatric hospital. We included demographics, indications, approach, and revision status. We evaluated preoperative and postoperative instrumental and functional swallow evaluations, and we also gathered information on airway outcomes. Thirty-one patients were included in the study. Median (interquartile range [IQR]) age was 4.0 (2.0, 7.0) years old. Primary indication for surgery was bilateral vocal cord immobility (BVCI) in 11 (35.5%) and posterior glottic stenosis (PGS) in 20 (64.5%). Mean (standard deviation) length of follow-up was 11.0 (8.3) months. Twelve patients had gastrostomy tubes (GT) before surgery, and no patients required placement of GT after surgery. Of the remaining 19 patients, 6 required nasogastric feeding for >4 weeks (average length 1.8 months, longest 3.5 months). At last follow-up, 25 (80.6%) patients were primarily orally fed. Eighteen patients had tracheotomies prior to surgery. No patients without a tracheostomy required placement of tracheostomy before or after surgery and only 1 patient had a tracheostomy at last follow-up. Average time to decannulation was 3.7 months, with surgery-specific success of 87.1% and overall success of 96.8%. Four (12.9%) patients required a major intervention to achieve decannulation. LTP PCCG is an effective surgical technique to address PGS and BVCI with high decannulation rates. It may cause temporary swallowing dysfunction, but in this series a majority of children were orally fed at last follow-up. 4 Laryngoscope, 131:2798-2804, 2021.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2798-2804Informations de copyright
© 2021 The American Laryngological, Rhinological and Otological Society, Inc..
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