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Review
. 2017 Jun;9(6):1663-1671.
doi: 10.21037/jtd.2017.05.50.

Pediatric airway surgery

Konrad Hoetzenecker  1 , Thomas Schweiger  1 , Doris Maria Denk-Linnert  2 , Walter Klepetko  1
Affiliations
Review

Pediatric airway surgery

Konrad Hoetzenecker et al. J Thorac Dis. 2017 Jun.

Abstract

The management of pediatric airway pathology can be challenging and requires a dedicated team, consisting of thoracic surgeons, phoniatricians, logopedics, pediatricians and anesthetists. It necessitates a tailored treatment approach for each individual patient in order to address the minor variances that exist between cases. The majority of pediatric airway problems are a sequela of prematurity and prolonged post-partal intubation/tracheostomy. Surgical repair is often complicated by additional malformation or severe comorbidities. This comprehensive review should give an overview on most common airway problems in neonates and children as well as available surgical techniques.

Keywords: Pediatric; airway; stenosis; surgical techniques.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Subglottic post-tracheostomy stenosis with 10 percent remaining cross section (Myer-Cotton III).
Figure 2
Figure 2
Standard cricotracheal resection. The cricoid arch is resected and a mucosectomy of the cricoid plate is performed. The mucosectomized cricoid plate is fully covered with a dorsal mucosal flap during the anastomosis. A running PDS suture is used to adapt the posterior part of the anastomosis, interrupted PDS stiches are used for the lateral and anterior aspect.
Figure 3
Figure 3
Principles of laryngotracheal reconstruction. The anterior and posterior glotto-subglottic airway is opened vertically and a rib cartilage graft is inserted to expand the diameter of the airway. Modified from Hoetzenecker et al. (28).
Figure 4
Figure 4
Surgical steps of an extended partial cricotracheal resection. After a complete anterior and posterior split of the larynx, a rib cartilage is inserted posterior. It is covered by a mucosal flap of the membraneous portion of the distal trachea. An LT mold is inserted to stabilize the reconstruction and the thyrotracheal anastomosis is completed. Modified from Hoetzenecker et al. (28).
Figure 5
Figure 5
Intraoperative situs of a slide tracheoplasty. The stenotic trachea is horizontally transected, the upper and lower part are slit anteriorly and posteriorly and the two fragments are slid into each other. Modified from Hoetzenecker et al. (28).
See this image and copyright information in PMC

References

    1. Eckel HE, Koebke J, Sittel C, et al. Morphology of the human larynx during the first five years of life studied on whole organ serial sections. Ann Otol Rhinol Laryngol 1999;108:232-8. 10.1177/000348949910800303 - DOI - PubMed
    1. Masaoka A, Yamakawa Y, Niwa H, et al. Pediatric and adult tracheobronchomalacia. Eur J Cardiothorac Surg 1996;10:87-92. 10.1016/S1010-7940(96)80129-1 - DOI - PubMed
    1. Wright CD, Graham BB, Grillo HC, et al. Pediatric tracheal surgery. Ann Thorac Surg 2002;74:308-13; discussion 314. 10.1016/S0003-4975(02)03613-5 - DOI - PubMed
    1. Monnier P. Pediatric airway surgery management of laryngotracheal stenosis in infants and children. 2011:xvii, 371 p.
    1. Walner DL, Loewen MS, Kimura RE. Neonatal subglottic stenosis--incidence and trends. Laryngoscope 2001;111:48-51. 10.1097/00005537-200101000-00009 - DOI - PubMed

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