Failed paediatric laryngotracheoplasty.

INTRODUCTION

Clinical experience with the surgical treatment of paediatric laryngeal stenosis is decreasing, and therefore it is important to highlight the factors that may contribute to failure.

METHOD: Retrospective study of 28 children undergoing laryngotracheoplasty (LTP) for laryngeal stenosis was carried out over an 11-year period.

RESULTS

Twenty-one patients were decannulated after their initial surgery. One child died prior to stent removal, and the initial surgery was unsuccessful in six patients. Four of these underwent a second LTP. Three additional patients were decannulated, including one patient following endoscopic surgery only. One child is waiting decannulation, one child has not undergone further surgery, and another has undergone multiple failed LTP and remains dependent on the tracheostomy.

CONCLUSIONS

Factors identified as contributing to surgical failure in this series included severity of stenosis, cause of stenosis, presence of gastro-oesophageal reflux, other airway abnormalities, timing of surgery, type of surgery employed, and factors related to post-operative management.