TY  - BOOK
AU  - Blumenthal, Daniel
AU  - Leonard, James
TI  - Decannulation in Revision Pediatric Laryngotracheal Reconstruction
SN  - 0023-852X
PY  - 2023///
KW  - IN PROCESS -- NOT YET INDEXED
KW  - Automated
KW  - MedStar Georgetown University Hospital/MedStar Washington Hospital Center
KW  - Otolaryngology Residency
KW  - Journal Article
N2  - 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)
UR  - https://dx.doi.org/10.1002/lary.30985
ER  -