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Otolaryngology – Head and Neck Surgery
Otolaryngology – Head and Neck Surgery

Laryngotracheal reconstruction

an image of a hole in the human body

The paediatric airway has been and still is an area of considerable expertise and innovation at The Hospital for Sick Children.

The late Blair Fearon introduced the world to laryngotracheoplasty in children in the 1970's. He also popularized the use of the CO2 laser for the paediatric airway in Canada. National as well as international fellows, residents and colleagues benefited tremendously from his unrelenting perseverance with this most difficult clinical entity. Work has continued at the hospital expanding upon his ideas.

William Crysdale performed the first anterior-posterior cricoid split in North America in 1974, as well as gaining considerable experience in the use of laryngeal stents.

More recently, Vito Forte has introduced the use of autogenous laryngeal cartilage as an alternative to rib cartilage as the graft of choice for moderately severe subglottic stenosis in the neonatal period and young child. Also he has successfully applied the principles of cricotracheal resection in adults, to children with severe subglottic stenosis.

Another area of recent innovation, developed by Vito Forte and Robert M Filler (Division of Paediatric General Surgery) has been the clinical use of the Palmaz stent for children with severe tracheobronchomalacia or collapse of the post-tracheoplasty trachea.

Also, much effort has gone into prevention of laryngotracheal problems by developing protocols for the management of the intubated and the failure to extubate neonate.

Much effort has gone into single stage reconstruction of the larynx for subglottic stenosis as well as single stage repair of laryngeal clefts in order to avoid long-term tracheotomy.

 

For publications related to this topic, please go to Pubmed.