Tracheotomy after laryngotracheopasty: Risk factors over 10years

• Published in: Journal of pediatric surgery 2014-08, Vol.49 (8), p.1206-1209
• Main Authors: Marom, Tal, Joseph, Rachel A., Grindle, Christopher R., Shah, Udayan K.
• Format: Article
• Language: English
• Subjects: Age; Airway; Graft; Subglottic stenosis; Tracheotomy; Weight
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2013.11.065

Subglottic stenosis (SGS) is the most common congenital and/or acquired laryngotracheal anomaly requiring tracheotomy in infants. We sought to determine factors associated with a greater likelihood of tracheotomy in symptomatic infants with SGS who underwent laryngotracheoplasty (LTP). Retrospective case series with chart review of patients undergoing single-stage LTP for SGS over a 10-year period (2001–2010) in a tertiary-care pediatric hospital. Twenty-two children (15 boys, 7 girls), with a mean gestational age of 32.5weeks, underwent LTP with and without interpositional grafting, at a median age of 89days. Ten patients (43%) required postoperative tracheotomy. Of patients weighing 5kg needed tracheotomy (p=0.003). The average length of stay for patients with a tracheotomy was 125days, while those without tracheotomy required only 58days (p=0.011). The grade of SGS (p=0.809), gender (p=0.968), age at surgery (p=0.178), and gestational age (p=0.117) were not significantly associated with the need for tracheotomy. Weight at surgery was significantly correlated with the likelihood of needing tracheotomy (p=0.003). Patients who weighed less than 2.5kg at the time of LTP procedures were more likely to require a postoperative tracheotomy. Children who required tracheotomy had longer lengths of hospital stay.