Laryngotracheal separation using skin flap formation: a novel surgical procedure

• Published in: Pediatric surgery international Vol. 27; no. 1; pp. 67 - 71
• Main Authors: Fukumoto, Koji, Urushihara, Naoto, Fukuzawa, Hiroaki, Sugiyama, Akihide, Nagae, Hideki, Watanabe, Kentaro, Mitsunaga, Maki, Akazawa, Satoshi, Hasegawa, Shiro
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-01-2011
• Subjects: Adolescent; Adult; Child; Child, Preschool; Female; Humans; Infant; Larynx - surgery; Male; Medicine; Medicine & Public Health; Original Article; Pediatric Surgery; Pediatrics; Skin; Surgery; Surgical Flaps; Trachea - surgery; Treatment Outcome; Young Adult; Tracheo-innominate artery fistula; Intractable aspiration; Laryngotracheal separation
• ISSN: 0179-0358; 1437-9813
• DOI: 10.1007/s00383-010-2710-6

Laryngotracheal separation is often performed to prevent intractable aspiration for children with severe mental and physical disabilities. However, tracheo-innominate artery fistula after surgery can occur as a severe complication and cause fatal hemorrhage. We have therefore developed a novel procedure to prevent tracheo-innominate artery fistula. Surgery was performed by making an H-shaped incision and creating skin flaps. The trachea was not raised anteriorly and the skin flaps were sutured to the trachea. We performed this procedure on nine patients, and no major complications occurred in any case. This procedure can be expected to reduce the occurrence of tracheo-innominate artery fistula.