Tracheal reconstruction.

Treatment of stenosing malformations of the pediatric airway has progressed from dilatation and occasional localized resection to radical resection or extended tracheoplastic reconstruction. Current preoperative evaluation includes high-contrast radiography, bronchography, often magnetic resonance imaging (MRI) or computed tomography (CT), and intraoperative bronchoscopy. Cardiopulmonary bypass may be essential for complicated reconstructions involving the carina and bronchi, but most other stenoses can be corrected without bypass. Balloon dilatation directed toward forceful posterior split of complete cartilage rings has shown recent promise in small infants. Segmental resection with anastomosis is preferred for localized lesions. Incision tracheoplasty with interposition cartilage grafting is the current choice for long stenoses.