Laryngotracheal reconstruction

Abstract

Laryngotracheal reconstruction (LTR) along with cricotracheal resection and thyrotracheal anastomosis has become the standard of care for symptomatic subglottic stenosis in the pediatric age group. Success rates in achieving decannulation or avoiding tracheotomy approach 90%. Fearon and Cotton introduced pediatric LTR in 1972 using cartilage interposition grafting. The procedure has evolved to include a variety of techniques for expanding the laryngotracheal complex to obtain a stable airway of sufficient size for respiration. In this chapter, the authors will describe their single and double-stage technique for LTR highlighting surgical pearls necessary for success.