Airway and Swallowing Outcomes following Laryngotracheoplast
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Laryngotracheoplasty with posterior grafting (LTP PCCG) is helpful in bilateral vocal cord immobility (BVCI) and posterior glottic stenosis (PGS) according to a recent study.

The objective of this study was to evaluate swallowing and airway outcomes following laryngotracheoplasty with posterior grafting (LTP PCCG).

A retrospective review of pediatric patients undergoing LTP PCCG at a tertiary care pediatric hospital was carried out. The researchers included demographics, indications, approach, and revision status. They evaluated preoperative and postoperative instrumental and functional swallow evaluations, and also gathered information on airway outcomes.

Thirty-one patients were included in the study. The median age was 4.0 years old. The primary indication for surgery was bilateral vocal cord immobility (BVCI) in 11 and posterior glottic stenosis (PGS) in 20. The mean length of follow-up was 11.0 months.

--Twelve patients had gastrostomy tubes (GT) before surgery, and no patients required placement of GT after surgery. Of the remaining 19 patients, 6 required nasogastric feeding for >4?weeks.

--At the last follow-up, 25 patients were primarily orally fed.

--Eighteen patients had tracheotomies prior to surgery. No patients without a tracheostomy required placement of tracheostomy before or after surgery and only 1 patient had a tracheostomy at the last follow-up.

--The average time to decannulation was 3.7?months, with the surgery-specific success of 87.1% and overall success of 96.8%. Four patients required a major intervention to achieve decannulation.

In conclusion, LTP PCCG is an effective surgical technique to address PGS and BVCI with high decannulation rates. It may cause temporary swallowing dysfunction, but in this series, a majority of children were orally fed at the last follow-up.

The Laryngoscope