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Airway reconstruction in pediatric burn patients

David R White1, Diego A Preciado, Becky Stamper

  • 1Department of Otolaryngology--Head and Neck Surgery, Cincinnati Children's Medical Center, OH 45229, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|September 7, 2005
PubMed

Insights

Pediatric burn victims undergoing laryngotracheal reconstruction (LTR) show similar outcomes to children with acquired stenosis. This study found no significant differences in decannulation rates or long-term airway patency between these groups.

Area of Science:

  • Pediatric surgery
  • Otolaryngology
  • Burn reconstruction

Background:

  • Laryngotracheal reconstruction (LTR) in pediatric burn victims is anecdotally reported to have lower success rates.
  • This study aimed to objectively compare LTR outcomes in pediatric burn patients versus a matched control group.

Purpose of the Study:

  • To compare the outcomes of laryngotracheal reconstruction (LTR) in pediatric burn victims with those in a control group of children with acquired stenosis.
  • To evaluate the clinical impression that LTR is less successful in pediatric burn patients.

Main Methods:

  • Retrospective case-control study design.
  • Reviewed records of 34 pediatric burn victims undergoing LTR.
  • Compared with 48 randomly selected, age- and stenosis-grade-matched children undergoing LTR for acquired stenosis.

Main Results:

  • No significant differences in decannulation rate after the first procedure, number of open airway procedures, or time to decannulation between groups.
  • Two tracheostomy-related deaths occurred in the burn group; one in the control group.
  • Two burn patients and three control patients remained tracheostomy-dependent at least one year post-reconstruction.

Conclusions:

  • Long-term outcomes of laryngotracheal reconstruction in pediatric burn patients are comparable to those in pediatric patients with acquired airway stenosis.
  • The study challenges the anecdotal impression of poorer LTR success in pediatric burn victims.
Abstract

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