Tracheal growth after airway stenosis surgery: serial radiographic comparative study

The proportion of stenotic area over normal tracheal lumen does not decrease over time after airway stenosis surgery regardless of endoscopic or open surgery, which suggests that the operated laryngotracheal complex may grow and develop similarly to the normal surrounding tissue.

To evaluate the effect of pediatric airway stenosis surgery on the growth of the laryngotracheal complex and to compare the differences between endoscopic and open surgery.

Forty-five successful stoma closures after pediatric airway stenosis surgery were performed between 2001 and 2007. Thirty patients had a minimal postoperative follow-up time of 3 years and were included in this study. Evaluation was based on a retrospective review of the patients' images and data. The parameters analyzed were: diameter of tracheal stenosis, diameter of normal trachea, and the ratio of stenotic area to normal tracheal lumen.

In all, 24 patients were treated with the endoscopic technique. Among the six open laryngotracheal reconstructions, cricoid splitting and rib cartilage graft were performed in four patients and laryngotracheal resection and end-to-end anastomosis were performed in two patients. Stenosis to normal ratio tended to increase after endoscopic intervention, but it did not show statistical significance (p = 0.082). Open surgery did not cause significant narrowing (p = 0.443).