000			03190nam a22004337a 4500
008			231220s20232023 xxu||||| |||| 00| 0 eng d
022			_a0023-852X
024			_a10.1002/lary.30985 [doi]
040			_aOvid MEDLINE(R)
099			_a37658702
245			_aDecannulation in Revision Pediatric Laryngotracheal Reconstruction.
251			_aLaryngoscope. 2023 Sep 02
252			_aLaryngoscope. 2023 Sep 02
253			_aThe Laryngoscope
260			_c2023
260			_fFY2024
260			_p2023 Sep 02
265			_saheadofprint
265			_tPublisher
266			_d2023-12-20
520			_aCONCLUSION: 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.
520			_aLEVEL OF EVIDENCE: 4 Laryngoscope, 2023. Copyright © 2023 The American Laryngological, Rhinological and Otological Society, Inc.
520			_aMETHODS: 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.
520			_aOBJECTIVES: To evaluate how patient characteristics and surgical techniques influence the rate of and time to decannulation after pediatric revision laryngotracheal reconstruction.
520			_aRESULTS: 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).
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
650			_zAutomated
656			_aMedStar Georgetown University Hospital/MedStar Washington Hospital Center
656			_aOtolaryngology Residency
657			_aJournal Article
700			_aBlumenthal, Daniel _bMGUH _cOtolaryngology Residency _dMD
700			_aLeonard, James _bMGUH _cOtolaryngology Residency _dMD
790			_aLeonard JA, Blumenthal DL, Behzadpour HK, Lawlor CM, Preciado D
856			_uhttps://dx.doi.org/10.1002/lary.30985 _zhttps://dx.doi.org/10.1002/lary.30985
858			_yBlumenthal, Daniel L _uhttps://orcid.org/0000-0002-6291-0726 _zhttps://orcid.org/0000-0002-6291-0726
858			_yLeonard, James A _uhttps://orcid.org/0000-0002-7955-0392 _zhttps://orcid.org/0000-0002-7955-0392
942			_cART _dArticle
999			_c13667 _d13667