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[Long-term results after modified Réthi-plasty in childhood]
H Olze1, H J Gerhardt, O Kaschke
1Universitätsklinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Medizinische Fakultät der Humboldt Universität zu Berlin, Charité.
Background:
Laminotomy as described by Réthi has proved useful in the treatment of laryngotracheal stenoses. Using this technique in children poses the question as to whether it interferes with the growth of the larynx and trachea. The aim of our study was to verify the influence of this operative procedure on the structure and function of the restored airway.
Patients:
Fifteen children between the ages of 2 and 16 with severe laryngotracheal stenoses (Cotton Grade III and IV) underwent reconstruction with interposition of a piece of costal cartilage in the posterior cricoid plate. Indications for this procedure included the presence of severe circumferential subglottic stenosis in combination with stenosis of the posterior glottis (8 children) and complete atresia (4 children).
Results:
In endoscopic follow-up examinations (2-12 years follow-up), complete epithelization with light stenosis in the subglottis was demonstrated in all cases. Airway ventilation tests showed a slight or moderate central obstruction in nearly all cases. No disturbance of growth of the larynx was noted.
Conclusions:
This technique is a safe and successful method for repairing severe subglottic stenoses in children. Although there are some structural and functional problems during the long term follow-up, this is not considered a significant disadvantage.