Laryngotracheal Reconstruction Outcomes in Children Born Extremely Premature.
Citation: Laryngoscope. 2023 Apr 26PMID: 37098816Department: MedStar Georgetown University Hospital/MedStar Washington Hospital Center | Otolaryngology ResidencyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXED | Year: 2023Local holdings: Available online from MWHC library: 1997 - present, Available in print through MWHC library: 1996 - 2003ISSN:- 0023-852X
- Blumenthal, Daniel:
- https://orcid.org/0000-0002-6291-0726 Leonard, James A:
- https://orcid.org/0000-0002-7955-0392
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
---|---|---|---|---|---|---|
Journal Article | MedStar Authors Catalog | Article | 37098816 | Available | 37098816 |
Available online from MWHC library: 1997 - present, Available in print through MWHC library: 1996 - 2003
CONCLUSION: Compared with all other patients, extremely premature infants have equivalent decannulation success, but are at an increased risk for complications following LTR.
INTRODUCTION: There has been a notable increase in the number of neonates born 28 weeks gestational age or younger in the United States. Many of these patients require tracheostomy early in life and subsequent laryngotracheal reconstruction (LTR). Although extremely premature infants often undergo LTR, there is no known study to date examining their post-surgical outcomes.
LEVEL OF EVIDENCE: 3 Laryngoscope, 2023. Copyright � 2023 The American Laryngological, Rhinological and Otological Society, Inc.
METHODS: We identified 179 patients treated at a stand-alone tertiary children's hospital who underwent open airway reconstruction from 2008 to 2021. A Chi Squared test was used to detect differences in categorical clinical data between the groups of patients. A Mann-Whitney test was used to analyze continuous data within these same groups. Time to decannulation analysis was performed using Kaplan Meier analysis and evaluated with log-rank and Cox proportional hazards regression.
OBJECTIVES: To compare decannulation rates, time to decannulation and complication rates between LTR patients born extremely premature to those born preterm and term.
RESULTS: Children born extremely premature were more likely to incur complications following LTR (OR = 2.363, p = 0.005, CI 1.295-4.247). There was no difference in time to decannulation (p = 0.0543, Log-rank) or rate of decannulation (OR = 0.4985, p = 0.05, CI 0.2511-1.008). Extremely premature infants were more likely to be treated with an anterior and posterior grafts (OR = 2.471, p = 0.004, CI 1.297-4.535) and/or an airway stent (OR = 3.112, p < 0.001, CI 1.539-5.987).
English