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Original Article |

Cervical Slide Tracheoplasty

Alessandro de Alarcon, MD, MPH; Michael J. Rutter, FRACS
Arch Otolaryngol Head Neck Surg. 2012;138(9):812-816. doi:10.1001/archoto.2012.1768.
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Published online

Objective  To describe our experience with cervical slide tracheoplasty (CST) in managing complex laryngotracheal disorders.

Design  Retrospective analysis.

Setting  Quaternary care pediatric institution.

Patients  The study included 29 patients who underwent CST without cardiopulmonary bypass at our institution from January 2003 to January 2011.

Main Outcome Measure  Surgery-specific and overall operative success.

Results  The most common airway lesion in our cohort of 29 patients (mean age, 10.7 years) was tracheal stenosis (n = 18); 10 of 18 patients had long-segment acquired tracheal stenosis. Operation-specific success was achieved in 23 of 29 patients (79%), including all 10 patients with long-segment acquired tracheal stenosis. Six patients failed initial CST and required additional surgical procedures. Overall success was achieved in 3 of these patients. Patients with subglottic stenosis (n = 7), concomitant glottic stenosis (n = 4), and multilevel airway lesions (n = 10) had lower operation-specific and overall operative success than did patients with other airway lesions. Four patients (14%) experienced complications.

Conclusions  Cervical slide tracheoplasty is a valuable technique that should be added to the surgical armamentarium for patients requiring open airway reconstruction. This technique yields a high success rate in treating patients with a broad spectrum of complex laryngotracheal disorders.

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Figures

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Grahic Jump Location

Figure 1. Long-segment tracheal stenosis before (A) and after (B) surgery.

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Figure 2. Endoscopic images of a tracheoesophageal fistula. A, Preoperative rigid endoscopic image. B, Preoperative flexible endoscopic image. C, After surgery.

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Grahic Jump Location

Figure 3. Severe “figure-of-8” deformity.

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