What is the efficacy and safety of bioabsorbable miniplates as an alternative to autologous grafts in single-stage laryngotracheal reconstruction for subglottic stenosis?
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August 2010Background: Since the 1960s, the incidence of acquired subglottic stenosis has dramatically increased due to the improved survival of low birth weight infants and the increased use of long-term endotracheal intubation in neonates. The majority of laryngotracheal airway expansion procedures for mild to moderate subglottic stenosis have relied on the use of autologous cartilage grafts. This study presents an alternative to this method, bioabsorbable miniplating.
Study design: Case series
Setting: Department of Otolaryngology, Case Western Reserve University, Cleveland, Ohio
Synopsis: Ten patients received a standard approach to the laryngotracheal complex with a poly-L-lactic-acid-polyglycolic-acid bioabsorbable miniplate placed over the cricoid defect. If there was concern for suprastomal collapse, additional plates were placed inferiorly. All patients had a well-healed and fully mucosalized anterior tracheal wall with no evidence of plate or suture exposure at the time of extubation. In addition, there were no postoperative complications directly attributable to the use of the absorbable plate, and all patients were successfully decannulated at the time of discharge. With follow-up ranging from 14 to 63 months, no patients required revision reconstruction or repeat tracheostomy
Bottom line: The use of bioabsorbable plates in select patients is a safe and effective alternative to the use of autologous cartilage grafts for single-stage laryngotracheal reconstruction for anterior subglottic stenosis.
Citation: Sprecher RC. Single-stage laryngotracheal reconstruction using bioabsorbable miniplates. Laryngoscope. 2010;120(8):1655-1661.
—Reviewed by Sue Pondrom