Reconstruction of the laryngotracheal complex in children using the sternocleidomastoid myocutaneous flap

Laryngotracheal stenosis in children should be treated effectively with minimal delay, and the tracheostomy should be closed within a reasonable period after surgery so that the child may develop normal speech and language. Successful reconstruction of the laryngotracheal complex was achieved by applying the superiorly based compound myocutaneous sternocleidomastoid muscle flap for wedge enhancement and resurfacing of the endolaryngeal and endotracheal lumen. A short stenting period, incorporating a custon-carved soft silicone laryngeal stent in direct continuity with an oversized silicone T-tube, helped in stabilizing the airway and ensuring good take of the flap. Postoperative recovery was relatively short, with good ventilation and vocal results. This single-step technique may be readily performed, and it interferes minimally with the child's development.