Surgical Treatment of Type III Laryngotracheoesophageal Clefts: Techniques and Outcomes.
Pediatric
laryngeal cleft
laryngotracheal cleft
surgery
swallowing
type III
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
revised:
17
08
2021
received:
24
05
2021
accepted:
20
08
2021
pubmed:
18
9
2021
medline:
13
4
2022
entrez:
17
9
2021
Statut:
ppublish
Résumé
Determine surgical and swallowing outcomes after surgery for type III laryngotracheoesophageal cleft (LTEC). Case series with chart review. Chart review was performed on patients with type III LTEC between 2000 and 2019. Demographics, surgical outcomes, and swallowing outcomes were collected and analyzed. Thirty-three patients met inclusion criteria (28 open and 5 endoscopic repairs). Mean age was 3.4 years for the open group and 0.9 years for the endoscopic group. Seventeen (51.5%) patients had a syndromic diagnosis, most commonly Opitz syndrome and Trisomy 21. Mean follow-up was 33.6 months. Thirteen (39.4%) patients had a previous repair attempt prior to repair at our institution. Twenty-four (70.6%) patients had a tracheostomy prior to or at the time of surgical repair and 13 (38.2%) remain tracheostomy-dependent. Nine patients (27.3%) required a revision cleft repair and four (12.1%) required two revisions. Thirty-one patients had an intact repair at last follow-up (93.9). Two patients died outside the hospital over a year after surgery. Preoperatively 13 of 17 patients with swallowing evaluations aspirated. After repair, 11 of 20 patients were deemed safe for all consistencies and seven were safe for thickened. Endoscopic approaches were performed during the last 2 years of the study and had significantly lower operative time (354.4 minutes vs. 171.5 minutes). Endoscopic and open approaches are effective for treatment of type III LTEC with 27.3% requiring revision and 93.9% of repairs intact at last follow-up. Overall swallowing outcomes were good in patients who underwent postoperative instrumental swallow evaluation. 4 Laryngoscope, 132:1112-1117, 2022.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1112-1117Informations de copyright
© 2021 The American Laryngological, Rhinological and Otological Society, Inc.
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