Airway reconstruction in children

SanjayR Rao, Ashley D′Cruz, Vinay Jadhav
2009 Journal of Indian Association of Pediatric Surgeons  
Full text online at outcome. Data was analyzed and results have been presented in this study. These children were evaluated using a standard data sheet. All children had a detailed history taken; emphasis was on the nature of airway obstruction symptoms, previous intubations and airway interventions, features of gastro esophageal reflux and current airway status. All children underwent a micro laryngo-bronchoscopy under general anesthesia; initially with spontaneous
more » ... ion and later paralysis if required. Children with airway foreign bodies and purely inflammatory pathology were excluded. A detailed assessment of the anatomy of the entire airway was made and cultures were collected as per the clinical indications. Based on this preliminary assessment, select patients underwent further imaging with computerized tomography (CT) scans and ECHO cardiograms. This was usually indicated with extrinsic compression of the airway was suspected. Gastro esophageal reflux studies were done when clinically indicated. Therapy was individualized; degree of symptoms, nature and degree of airway obstruction and nature of previous airway interventions were primary factors ABSTRACT Aim/Background: Airway anomalies are infrequent but potentially life threatening in children. A program to care for these difficult children was set up at our institution, and this paper summarizes our experience. Methods: A total of 34 children were enrolled in the program over a period of three years. These children were evaluated as per the standard protocols. Treatment was individualized. Results: Of these 34 children, 28 had their airways restored and are doing well. Four children continue to remain on tracheostomy and two will require long term tracheostomy. There were two deaths. All children are under surveillance as there is a risk of recurrence. Conclusions: Airway anomalies are complex problems with significant morbidity and mortality. Current therapeutic modalities allow for good results. Most children were successfully decannulated and did well.
doi:10.4103/0971-9261.57699 pmid:20376248 pmcid:PMC2847143 fatcat:34eafiaobvdy7b6qzpnh56dfki