Treatment of laryngotracheal stenosis with anterior and posterior cartilage grafts. A report of 41 children.

Forty-one tracheotomy-dependent children with moderate and severe laryngotracheal stenosis (Cotton grades III and IV) underwent laryngotracheal reconstruction with simultaneous use of costal cartilage grafts in the anterior and posterior subglottis and posterior glottis. The indications for this procedure are the presence of stenosis in the posterior part of the glottis, subglottis, or both in combination with anterior subglottic or upper tracheal narrowing. Other indications are the presence of circumferential subglottic stenosis, bilateral subglottic shelves, or total subglottic obstruction. The complications of this procedure included pneumothorax (one patient) and granulation tissue formation (five patients). There were two deaths unrelated to the reconstructive procedure. This technique offers an excellent opportunity for repair of laryngotracheal stenosis with a better than 90% tracheotomy decannulation rate after a single procedure within a short period after removal of the stent.