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Comparison of Outcomes Between Primary Laryngotracheal Reconstruction and Partial Cricotracheal Resection in Moderate

Bigyan Raj Gyawali1, Heempali Dutta1, Anuj Devkota1

  • 1Department of ENT and Head Neck Surgery Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital Kathmandu Nepal.

Laryngoscope Investigative Otolaryngology
|July 18, 2025
PubMed

Insights

Laryngotracheal reconstruction (LTR) and partial cricotracheal resection (PCTR) offer comparable success rates for pediatric subglottic stenosis. Partial cricotracheal resection may provide better functional outcomes, but more research is needed.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Airway Surgery
  • Respiratory Medicine

Background:

  • Moderate-grade pediatric subglottic stenosis (severe Grade II and III) requires surgical intervention.
  • Laryngotracheal reconstruction (LTR) and partial cricotracheal resection (PCTR) are common surgical techniques.
  • A clear consensus on the optimal surgical approach is lacking.

Purpose of the Study:

  • To systematically compare the outcomes of primary laryngotracheal reconstruction (LTR) versus partial cricotracheal resection (PCTR).
  • To evaluate surgical success in managing moderate-grade pediatric subglottic stenosis.

Main Methods:

  • Systematic literature search of PubMed, Embase, and Scopus adhering to PRISMA guidelines.
  • Inclusion of studies on pediatric patients (<18 years) with severe Grade II or III subglottic stenosis.
  • Primary outcome: successful extubation or decannulation; statistical analysis using STATA.

Main Results:

  • 24 studies included 193 patients (LTR) and 88 patients (PCTR).
  • Successful decannulation rates: 83.93% (LTR) vs. 96.59% (PCTR), not statistically significant (p=0.47).
  • PCTR showed slightly better voice/swallowing outcomes; LTR had higher restenosis/revision rates.

Conclusions:

  • Both LTR and PCTR are effective for moderate-grade pediatric subglottic stenosis with similar decannulation success.
  • PCTR may offer advantages in functional outcomes.
  • Further research with standardized reporting is needed to determine the optimal surgical approach.
Abstract

Keywords:
airway surgerylaryngotracheal reconstructionmeta‐analysispartial cricotracheal resectionpediatric subglottic stenosis

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