PMID: 8604897Apr 1, 1996Paper

Postoperative care following single-stage laryngotracheoplasty

The Annals of Otology, Rhinology, and Laryngology
N M BaumanR J Smith

Abstract

Single-stage laryngotracheoplasty (SSLTP) provides a method of correcting mild-to-moderate laryngotracheal stenosis while avoiding the risks of prolonged laryngeal stenting. Pediatric patients are orally intubated for 5 to 7 days postoperatively to ensure an adequate airway while edema resolves and healing begins. During this period, continuous neuromuscular blockade has been advocated in infants and young children to avoid endotracheal tube trauma to the fresh graft and potentially life-threatening accidental decannulation. Pulmonary atelectasis is the most common morbidity associated with prolonged neuromuscular blockade. Neuromuscular weakness also may follow prolonged paralysis and prolong hospitalization. This paper compares the postoperative course of 17 patients who underwent 18 SSLTP procedures by the senior author. The first 8 patients received continuous neuromuscular blockade in the early postoperative period. To reduce perceived morbidity, the last 9 patients were managed with a protocol that incorporated daily 4- to 8-hour "interruptions" of paralysis. Seven patients tolerated this protocol modification. As a group, these patients had less postoperative pulmonary atelectasis prior to extubation (p < .05) and were e...Continue Reading

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Citations

Feb 15, 2011·Auris, Nasus, Larynx·Ireneusz Bielecki, Mariusz Cofała
Jul 14, 2010·International Journal of Pediatric Otorhinolaryngology·Caitlin P McMullenSanjay R Parikh
Mar 9, 2010·International Journal of Pediatric Otorhinolaryngology·Scott A SchraffJ Paul Willging
Apr 12, 2016·International Journal of Pediatric Otorhinolaryngology·Eric BauerCharles A Elmaraghy
Feb 24, 2007·International Journal of Pediatric Otorhinolaryngology·Namit AgrawalGavin Morrison
Nov 10, 2004·International Journal of Pediatric Otorhinolaryngology·A Safdar, J D Russell
Jan 19, 2000·Otolaryngologic Clinics of North America·R T Cotton
Aug 13, 2013·International Journal of Pediatric Otorhinolaryngology·Matthew A PowersPeggy E Kelley
May 12, 2005·International Journal of Pediatric Otorhinolaryngology·P P RoeleveldM de Hoog
Oct 6, 2000·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·L M GustafsonR T Cotton
May 22, 1998·The Annals of Otology, Rhinology, and Laryngology·R F WardM M April
Apr 29, 2004·The Annals of Otology, Rhinology, and Laryngology·Benjamin B CableRichard J H Smith
Jul 3, 2013·The Annals of Otology, Rhinology, and Laryngology·Elena B WillisJohn P Bent
Dec 1, 1999·The Annals of Otology, Rhinology, and Laryngology·J P LudemannL D Holinger
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Jan 26, 2007·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Mehrengise K Cooper, Scot T Bateman
Feb 16, 2019·The Annals of Otology, Rhinology, and Laryngology·Prasad John ThottamDeepak Mehta
Feb 15, 2001·Critical Care Medicine·B R JacobsR J Brilli
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Aug 21, 2013·The Annals of Otology, Rhinology, and Laryngology·Jennifer SetlurChristopher J Hartnick
Jun 18, 2003·Pediatric Clinics of North America·William F McGuirt

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