Unique Airway Reconstruction Approach Results in Successful Repair, Easier Recovery
More repairs of complex tracheal stenosis have been performed at Cincinnati Children’s Hospital Medical Center than at any other hospital in the world.
Michael Rutter, MD, pediatric otolaryngologist, and Peter Manning, MD, director of the Cardiothoracic Surgery Division, have collaborated closely on more than 70 tracheal reconstructions with slide tracheoplasty. The key to their success, say the surgeons, is close collaboration among a variety of medical disciplines.
Case Study
An example of this collaborative approach occurred in August 2008, when a 1-year-old boy from the Dominican Republic underwent a successful slide tracheoplasty on cardiopulmonary bypass.
Prior to his arrival at Cincinnati Children’s, the patient had been treated at other hospitals; one of these included a successful surgery to correct a pulmonary artery sling. However, three pericardial patch tracheoplasties failed to resolve the initial diagnosis of congenital tracheal stenosis. A tracheal stent was inserted to manage severe tracheomalacia from the pericardial patch.
After being transferred to Cincinnati Children’s, the patient was weak and significantly underweight, the result of many months spent in intensive care units. Doctors performed a bronchoscopy and removed the stent; the patient was extubated and his condition improved.
A month later, his distal tracheal stenosis worsened. Rutter performed a balloon dilation of the distal tracheal airway, which stabilized the airway and enabled the boy to stay out of the hospital.
Ultimately, the patient had a successful tracheal reconstruction with a slide tracheoplasty. Upon a follow-up examination and bronchoscopy in October 2008, the patient’s tracheal stenosis had resolved, and he had virtually no airway symptoms whatsoever.
