Jayawardena ADL, Burks CA, Hartnick CJ. Bioabsorbable Microplates as an External Stent for Suprastomal Collapse: A Retrospective Review.
Laryngoscope 2020;
131:E631-E634. [PMID:
32330306 DOI:
10.1002/lary.28699]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 03/16/2020] [Accepted: 04/07/2020] [Indexed: 01/06/2023]
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.
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