Decannulation in Revision Pediatric Laryngotracheal Reconstruction. 

 -  2023 
<br/><br/> CONCLUSION: We observe that in the case of revision pediatric open airway surgery, chance of decannulation is improved when surgery is performed in a single stage as well as 6 months after the most recent procedure. Patients and families should be counseled that complex stenosis requiring double stage procedures or anterior/posterior grafting is associated with a decreased probability of decannulation and increased postoperative time with a tracheostomy, respectively.  LEVEL OF EVIDENCE: 4 Laryngoscope, 2023. Copyright © 2023 The American Laryngological, Rhinological and Otological Society, Inc.  METHODS: The study was a retrospective cohort investigation of children with a history of laryngotracheal stenosis treated between 2008 and 2021 with revision open airway surgery. The primary outcome evaluated was decannulation. The secondary outcome analyzed was time to decannulation.  OBJECTIVES: To evaluate how patient characteristics and surgical techniques influence the rate of and time to decannulation after pediatric revision laryngotracheal reconstruction.  RESULTS: Thirty-nine children were included in the study with median age 49 months; 61.5% were male. Children undergoing single stage revision surgery were far more likely to be decannulated (OR 6.25, 95% CI 1.33-45.97, p = 0.0343). Rolling logistic regression of the probability of decannulation stratified by time between open surgeries demonstrated significantly decreased chance of decannulation with reoperation within 6 months. Children managed with anterior/posterior grafting compared with a single graft were observed to have an increased time to decannulation, (HR 0.365, 95% CI 0.148-0.899, p = 0.005, Log-Rank). 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>0023-852X 
<br/><br/><label>Standard No.: </label>10.1002/lary.30985 [doi] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>IN PROCESS -- NOT YET INDEXED--Automated
<br/><br/><label>Index Terms--Occupation: </label><br/>MedStar Georgetown University Hospital/MedStar Washington Hospital Center<br/>Otolaryngology Residency
<br/><br/><label>Index Terms--Function: </label><br/>Journal Article