Abstract â–¡ 178

Laryngotracheal stenosis (LTS) is commonly encountered in the pediatric population and is usually due to prolonged intubation. Management of advanced LTS, when the lumen is totally or nearly totally occluded is surgical. The stenotic segment may be resected and anastamosed, or tracheoplasty may be performed. Neonates who are often intubated for prolonged periods, may develop subglottic stenosis during the first weeks of life and they are treated by an anterior cricoid split (ACS), while retaining the endotracheal tube as a stent.

Between 1993 to 1998 we performed 16 surgical procedures for the correction of LTS on 16 patients at the Soroka University Medical Center. Three of them were neonates with subglottic stenosis and they underwent ACS successfully, but one of them died later, due to ongoing respiratory failure. Thirteen patients underwent laryngotracheal reconstruction with the Aboulker stent. In the three most recent cases costal and cartilage interposition was also used. Five of these patients were children aged three to 14 and eight were adults. Four out of the five pediatric patients and seven out of the eight adults achieved decanulation.

Laryngotracheal reconstruction with the Alboulker stent in adults and children and with ACS in neonates were found to be effective surgical procedures. We present the clinical manifestations, surgical indications and the surgical procedures of this series of patients.