Irradiated homologous costal cartilage grafts for single-stage open airway reconstruction in severe subglottic stenosis for children under the age of one.

We present two cases of premature infants with Cotton-Myer grade 3 subglottic stenosis where endoscopic balloon dilation failed. In an attempt to avoid tracheostomy, both patients underwent open single stage anterior graft larnygotracheoplasty (LTP) with irradiated homologous rib and temporalis fascia grafts. After postoperative reconstruction, the airway was resized to grade 1 in one child, and to grade 2 in the other. One child remained free of stridor post-operatively and avoided the need of a tracheostomy tube. The other child ultimately required a tracheostomy, though she is now in the process of being decannulated. Homologous costal cartilage grafts in open anterior airway LTP may be a reasonable alternative to tracheostomy in young patients with advanced SGS.