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Thyroid ala cartilage graft laryngotracheoplasty for closure of large pediatric tracheocutaneous fistula.
MedLine Citation:
PMID:  23073169     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We describe a novel technique for closure of a large, persistent, pediatric tracheocutaneous fistula using a thyroid ala cartilage graft. Case report and review of the literature. We report 2 cases of large (>4mm), pediatric tracheocutaneous fistulas, in which primary closure of the tracheal defect would have caused critical airway narrowing and were managed with an anterior laryngotracheal reconstruction with a thyroid ala cartilage graft and closure of the tracheocutaneous fistula. The patients were extubated immediately postoperatively and maintained successfully closed fistulas with no clinically significant airway compromise. One of the considerations in pediatric tracheocutaneous fistula closure is to assess how the airway luminal diameter will be affected by primary closure of the tracheal defect. If primary closure of the tracheal opening causes critical airway narrowing because of a large tracheocutaneous fistula, a thyroid ala cartilage graft may be used for laryngotracheoplasty and allow for primary closure with a layered closure of the overlying strap muscles and soft tissue.
Authors:
Jeffrey Cheng; Ian Jacobs
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-13
Journal Detail:
Title:  International journal of pediatric otorhinolaryngology     Volume:  -     ISSN:  1872-8464     ISO Abbreviation:  Int. J. Pediatr. Otorhinolaryngol.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003603     Medline TA:  Int J Pediatr Otorhinolaryngol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Division of Pediatric Otolaryngology, The Center for Pediatric Airway Disorders, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA. Electronic address: chengj1@email.chop.edu.
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