This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (12)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Cancer Reconstruction of Head & Neck  • Otolaryngology/ Head & Neck Surgery, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

The Great Ormond Street Experience and Guidelines for Patient Selection

Chapman T. McQueen, MD; Nina L. Shapiro, MD; Susanna Leighton, MD, FRCS; Xu G. Guo; David M. Albert, MD, FRCS

Arch Otolaryngol Head Neck Surg. 1999;125:320-322.

Objectives  To review all patients undergoing single-stage laryngotracheal reconstruction and to determine guidelines to predict successful outcomes and prevent the necessity of tracheotomy following laryngotracheal reconstruction.

Design  Chart review.

Setting  Tertiary care children's hospital.

Patients  A retrospective chart review was performed at our institution involving all patients who underwent single-stage laryngotracheal reconstruction from 1993 through 1996. A total of 28 patients were reviewed.

Results  Based on this chart review, a statistically higher incidence of extubation complications (P=.045), ie, bleeding, reintubation, or subcutaneous emphysema, occurred in children who weighed less than 4 kg. Although not statistically significant (P>.99), the relative risks of failure, defined as tracheotomy dependent or significant airway compromise following single-stage laryngotracheal reconstruction, were 3.43 if the child's weight was less than 4 kg at the time of surgery and 2.31 if the gestational age was less than 30 weeks at the time of surgery. Length of time for intubation did not appear to have any effect on outcome.

Conclusions  Patients' gestational age and weight at the time of surgery appear to have the most impact on successful outcome. Children weighing more than 4 kg and those with gestational age of greater than 30 weeks appear to have a greater chance at successful extubation and eventual patent airway. Duration of intubation following single-stage laryngotracheal reconstruction does not appear to affect outcome.

From the Division of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill (Dr McQueen); Department of Pediatric Otolaryngology, University of California, Los Angeles (Dr Shapiro); Department of Pediatric Otolaryngology, Hospital for Sick Children, London, England (Drs Leighton and Albert); and Department of Statistical Analysis, University of North Carolina School of Public Health, Chapel Hill (Mr Guo).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Anterior and posterior cartilage graft dimensions in successful laryngotracheal reconstruction.
Koltai et al.
Arch Otolaryngol Head Neck Surg 2006;132:631-634.
ABSTRACT | FULL TEXT