Bioabsorbable Microplates as an External Stent for Suprastomal Collapse: A Retrospective Review. (24th April 2020)

• Record Type: Journal Article
• Authors: Jayawardena, Asitha D. L.; Burks, Ciersten A.; Hartnick, Christopher J.
• Is Part Of: Laryngoscope. Volume 131:Number 2(2021)
• Page Start: E631
• Page End: E634
• Publication Date: 2020-04-24
• Subjects: Laryngotracheal stenosis -- pediatric airway -- suprastomal collapse -- subglottic stenosis -- tracheostomy dependence -- laryngotracheal reconstruction -- decannulation -- external laryngeal stent; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.28699
• Languages: English
• ISSNs: 0023-852X

Abstract

Abstract : Objective/Hypothesis: To assess the long‐term decannulation outcomes of bioresorbable microplates as an external stent for pediatric tracheostomy patients with suprastomal collapse. Study Design: Retrospective cohort study. Methods: Hospital records of all patients who underwent a bioresorbable microplate for suprastomal collapse from 2016 to 2019 were reviewed at a single institution. The primary outcome measure was tracheostomy decannulation. Results: A total of nine patients underwent placement of bioabsorbable microplates to treat suprastomal collapse. After initial tracheostomy, four patients received a laryngotracheal reconstruction prior to their external stent placement, and one patient received a mandibular distraction. The average age at the time of external stent placement was 32 (±21) months, excluding one patient who received a stent at the age of 29 years. Eight patients (88.9%) were successfully decannulated following the procedure. Decannulated patients were followed for an average of 21 (±12.5) months postoperatively, and all these patients have remained decannulated since their initial procedure. This is a total of 173 months (14.4 years) of observation postprocedure in which these patients have remained decannulated. One patient experienced postoperative crepitus requiring washout but still maintained decannulation. Conclusion: Bioabsorbable microplates have a reasonable chance of long‐term successful decannulation when an appropriate patient is selected. Decannulation is maintained beyond the 6‐month time frame in which the 85:15 poly(L‐lactide‐co‐glycolide) polymer that comprises the external stent takes to bioabsorb. This procedure should be considered for the often difficult problem of pediatric tracheostomy with isolated suprastomal collapse. Level of Evidence: 4 Laryngoscope, 131:E631–E634, 2021