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Anaesthesia for laryngotracheal surgery in children: a narrative review

Rachele Bonfiglio1, Nicola Disma1, Alexander Fuchs2

  • 1Department of Paediatric Anaesthesia, Unit for Research in Anaesthesia, IRCCS Istituto Giannina Gaslini, Genoa, Italy.

Current Opinion in Anaesthesiology
|July 21, 2026
PubMed

Insights

Paediatric laryngotracheal surgery requires tailored approaches for airway reconstruction and ventilation. A multidisciplinary team focusing on patient physiology and airway techniques is crucial for successful outcomes in these complex procedures.

Area of Science:

  • Pediatric Surgery
  • Anesthesiology
  • Otolaryngology

Background:

  • Paediatric laryngotracheal surgery addresses complex airway pathologies.
  • The shared-airway setting presents unique surgical and anaesthetic challenges.

Purpose of the Study:

  • To review current literature on paediatric laryngotracheal surgery.
  • To focus on surgical techniques, anaesthetic management, and ventilation strategies.
  • To provide a multidisciplinary framework for clinicians.

Main Methods:

  • Literature review integrating recent evidence.
  • Analysis of evolving surgical and anaesthetic practices.
  • Focus on shared-airway management and perioperative approaches.

Main Results:

  • Shift towards lesion-specific reconstruction, including endoscopic techniques and posterior cricoid split.
  • Adaptive ventilation strategies are increasingly utilized (spontaneous, jet, controlled).
  • Emphasis on first-attempt success, preoxygenation, and multidisciplinary coordination.

Conclusions:

  • Meticulous planning and flexible airway strategies are essential.
  • Individualized ventilation, oxygenation, and postoperative care optimize outcomes.
  • Proficiency in multiple airway techniques is vital for personalized, physiology-protective management.
Abstract

Keywords:
airway managementchildrenjet ventilationlaryngotracheal surgeryoxygenation

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