Laryngotracheal reconstruction in congenital laryngeal webs and atresias

Otolaryngol Head Neck Surg. 2005 Feb;132(2):232-8. doi: 10.1016/j.otohns.2004.09.032.


Objective: To review the role of open laryngotracheal reconstruction (LTR) in congenital laryngeal webs and atresias.

Study design and setting: A retrospective chart review was undertaken in a specialist otorhinolaryngology unit in an academic tertiary referral paediatric hospital. Twenty-one patients with congenital laryngeal subglottic stenosis (SGS) underwent LTR between 1993 and 2003. Two groups were identified; one group had SGS alone (n = 6) and the other group had SGS associated with a laryngeal web (n = 15). Information recorded included presenting features, classification of lesion, surgery performed, and whether decannulation was achieved.

Results: All grades of stenosis (Myer-Cotton classification) and webs of type 2, 3, and 4 (Cohen's classification) were recorded. Fifteen patients had a staged reconstruction and 6 patients had a single-stage LTR. Complications included 2 revision procedures, 3 tracheocutaneous fistulas, and 1 death (cause unrelated). All appropriate patients were successfully decannulated at between 3 and 18 months post-LTR (median, 5 months).

Conclusion: This series illustrates the effective role of open LTR in both congenital SGS alone and that in association with glottic webbing.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Laryngostenosis / congenital*
  • Laryngostenosis / surgery*
  • Larynx / abnormalities*
  • Larynx / surgery*
  • Male
  • Otorhinolaryngologic Surgical Procedures / adverse effects
  • Reoperation
  • Retrospective Studies
  • Severity of Illness Index
  • Trachea / surgery*
  • Treatment Outcome