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January 1992, Vol 118, No. 1 >
ARTICLE | January 1992

Anastomosis of the Cervical Trachea in Children FREE

Brian J. Wiatrak, MD; Robin T. Cotton, MD
[+] Author Affiliations

Accepted for publication September 13, 1991.

Presented at the International Congress of Pediatric Otolaryngology, Ghent, Belgium, June 1990.

Reprint requests to 2451 Taubman Center, Box 0313,1500 E Medical Center Dr, Ann Arbor, MI 48109-0313 (Dr Wiatrak).


Arch Otolaryngol Head Neck Surg. 1992;118(1):58-62. doi:10.1001/archotol.1992.01880010062017
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References
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• Numerous techniques for the surgical management of laryngotracheal stenosis in children have been described in the literature. These surgical modalities include endoscopic management and open laryngotracheal reconstruction using costal cartilage grafts for expansion of the stenotic subglottic region. Although tracheal resection with primary reanastomosis for the management of tracheal stenosis is reported frequently in the adult population, children rarely have stenotic lesions that are amenable to this particular technique. Laryngotracheal stenosis in children most commonly involves the subglottis. This makes tracheal resection with anastomosis technically difficult to perform, due to the close proximity of the vocal cords. We have found a subpopulation of children at our institution with high tracheal stenoses, with minimal lower subglottic involvement, who were amenable to tracheal resection with primary anastomosis. We review our experience with this technique. The indications for this surgical modality in children are discussed, as well as the surgical technique.

(Arch Otolaryngol Head Neck Surg. 1992;118:58-62)

REFERENCES

1 +
Cotton RT, Evans JGN.  Laryngotracheal reconstruction in children . Ann Otorhinolaryngol. 1981;;90:516-520.
2 +
Cotton RT, Gray SD, Miller RP.  Update of the Cincinnati experience in pediatric laryngotracheal reconstruction . Laryngoscope . 1989;;99:111-116.
3 +
Rethi A.  An operation for cicatricial stenosis of the larynx . J Laryngol Otol. 1956;;70:283-293.
4 +
Evans JNG.  Laryngotracheoplasty . Otolaryngol Clin North Am. 1977;;10:119-123.
5 +
Grahne B.  Operative treatment of severe traumatic laryngeal stenosis in infants up to 3 years old . Acta Otolaryngol. 1971;;77:134-137.
6 +
Healy GB.  An experimental model for the endoscopic correction of subglottic stenosis with clinical applications . Laryngoscope . 1982;;92:1103-1115.
7 +
Strong MS, Healy GB, Vaughn CW, Fried MP, Shapshay S.  Endoscopic management of laryngeal stenosis . Otolaryngol Clin North Am. 1979;;12:797-805.
8 +
Ward PH, Canalis R, Fee W, Smith G.  Composite hyoid sternohyoid muscle grafts in humans . Arch Otolaryngol. 1977;;103:531-534.
9 +
Eliachar I, Welker KB, Roberts JK, Tucker HM.  Advantages of the rotary door flap in laryngotracheal reconstruction: is skeletal support necessary? Ann Otol Rhinol Laryngol. 1989;;98:37-40.
10 +
Cotton RT, Myer CM III.  Contemporary surgical management of laryngeal stenosis in children . Am J Otolaryngol. 1984;;5:360-368.
11 +
Healy GB, Jonas RA, Schuster SR, McGill TJ.  Correction of segmental tracheal stenosis in children . Ann Otol Rhinol Laryngol. 1988;;97:444-447.
12 +
Tucker HM.  Double-barreled (diversionary) tracheostomy in the management of juvenile laryngeal papillomatosis . Ann Otol Rhinol Laryngol. 1980;;89:504-507.
13 +
Cotton RT, Seid AB.  Management of the extubation problem in the premature child . Ann Otol Rhinol Laryngol. 1980;;89:508-511.
14 +
McDonald IH, Stocks J.  Prolonged nasotracheal intubation . Br J Anaesth . 1965;;37:161-167.
15 +
Cotton RT, Manoukian JJ.  Glottic and subglottic stenosis . In: Cummings CW, ed. Otolaryngology—Head and Neck Surgery . St Louis, Mo: Mosby—Year Book Co; 1986;.
16 +
Grillo HC, Zannini P.  Management of obstructive tracheal disease in children . J Pediatr Surg. 1984;;19:414-416.
17 +
Grillo HC.  Primary reconstruction of airway after resection of subglottic laryngeal and upper tracheal stenosis . Ann Thorac Surg. 1982;;33:3-18.
18 +
Carcassonne M, Dor V, Aubert J, Kreitman P.  Tracheal resection with primary anastomosis in children . J Pediatr Surg. 1973;;8:1-8.
19 +
Louhimo I, Grahne B, Parila M, Suutarinen T.  Acquired laryngotracheal stenosis in children . J Pediatr Surg. 1971;;6:730-737.
20 +
Chodosh PL.  Cricoid fracture with tracheal avulsion . Arch Otolaryngol. 1968;;87:461-467.
21 +
Conley JJ.  Reconstruction of the subglottic air passage . Ann Otol Rhinol Laryngol. 1953;;62:477-495.
22 +
Aboulker P, Sterkers JM, Demaldent JE, Sauton P.  Modifications apportées a l'intervention de Rethi, interèt dans les stenoses laryngo-tracheales et tracheales . Ann Otolaryngol. 1966;;83:98-106.

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1 +
Cotton RT, Evans JGN.  Laryngotracheal reconstruction in children . Ann Otorhinolaryngol. 1981;;90:516-520.
2 +
Cotton RT, Gray SD, Miller RP.  Update of the Cincinnati experience in pediatric laryngotracheal reconstruction . Laryngoscope . 1989;;99:111-116.
3 +
Rethi A.  An operation for cicatricial stenosis of the larynx . J Laryngol Otol. 1956;;70:283-293.
4 +
Evans JNG.  Laryngotracheoplasty . Otolaryngol Clin North Am. 1977;;10:119-123.
5 +
Grahne B.  Operative treatment of severe traumatic laryngeal stenosis in infants up to 3 years old . Acta Otolaryngol. 1971;;77:134-137.
6 +
Healy GB.  An experimental model for the endoscopic correction of subglottic stenosis with clinical applications . Laryngoscope . 1982;;92:1103-1115.
7 +
Strong MS, Healy GB, Vaughn CW, Fried MP, Shapshay S.  Endoscopic management of laryngeal stenosis . Otolaryngol Clin North Am. 1979;;12:797-805.
8 +
Ward PH, Canalis R, Fee W, Smith G.  Composite hyoid sternohyoid muscle grafts in humans . Arch Otolaryngol. 1977;;103:531-534.
9 +
Eliachar I, Welker KB, Roberts JK, Tucker HM.  Advantages of the rotary door flap in laryngotracheal reconstruction: is skeletal support necessary? Ann Otol Rhinol Laryngol. 1989;;98:37-40.
10 +
Cotton RT, Myer CM III.  Contemporary surgical management of laryngeal stenosis in children . Am J Otolaryngol. 1984;;5:360-368.
11 +
Healy GB, Jonas RA, Schuster SR, McGill TJ.  Correction of segmental tracheal stenosis in children . Ann Otol Rhinol Laryngol. 1988;;97:444-447.
12 +
Tucker HM.  Double-barreled (diversionary) tracheostomy in the management of juvenile laryngeal papillomatosis . Ann Otol Rhinol Laryngol. 1980;;89:504-507.
13 +
Cotton RT, Seid AB.  Management of the extubation problem in the premature child . Ann Otol Rhinol Laryngol. 1980;;89:508-511.
14 +
McDonald IH, Stocks J.  Prolonged nasotracheal intubation . Br J Anaesth . 1965;;37:161-167.
15 +
Cotton RT, Manoukian JJ.  Glottic and subglottic stenosis . In: Cummings CW, ed. Otolaryngology—Head and Neck Surgery . St Louis, Mo: Mosby—Year Book Co; 1986;.
16 +
Grillo HC, Zannini P.  Management of obstructive tracheal disease in children . J Pediatr Surg. 1984;;19:414-416.
17 +
Grillo HC.  Primary reconstruction of airway after resection of subglottic laryngeal and upper tracheal stenosis . Ann Thorac Surg. 1982;;33:3-18.
18 +
Carcassonne M, Dor V, Aubert J, Kreitman P.  Tracheal resection with primary anastomosis in children . J Pediatr Surg. 1973;;8:1-8.
19 +
Louhimo I, Grahne B, Parila M, Suutarinen T.  Acquired laryngotracheal stenosis in children . J Pediatr Surg. 1971;;6:730-737.
20 +
Chodosh PL.  Cricoid fracture with tracheal avulsion . Arch Otolaryngol. 1968;;87:461-467.
21 +
Conley JJ.  Reconstruction of the subglottic air passage . Ann Otol Rhinol Laryngol. 1953;;62:477-495.
22 +
Aboulker P, Sterkers JM, Demaldent JE, Sauton P.  Modifications apportées a l'intervention de Rethi, interèt dans les stenoses laryngo-tracheales et tracheales . Ann Otolaryngol. 1966;;83:98-106.

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