Otolaryngology

Pediatric Airway Reconstruction

Specialized Experts in Reconstruction
Airway reconstructions are not always straightforward procedures. The specialized team of surgeons at Cincinnati Children’s estimates to have performed more open airway reconstructions than anywhere else in the world, helping to ensure that your child will receive experienced, comprehensive and dedicated care.

Pioneering Work in Otolaryngology
The Division of Pediatric Otolaryngology - Head and Neck Surgery at Cincinnati Children’s is expanding the surgical horizons of airway reconstruction. We utilize new techniques and procedures, and are researching new ways to use topical steroids and antibiotics in our patient’s treatment plans.

Leading the Way in Vocal Reconstruction
Cincinnati Children’s is also at the forefront of vocal reconstruction, an issue that sometimes does not appear until a child reaches the teenage years. Our team studies a wide range of vocal outcomes from airway reconstruction surgeries, and is using that information to offer solutions to children experiencing voice issues.

Individualized Treatment
We strive to assess all aspects of a child and individualize a treatment plan that encompasses all levels of care. If surgery is the best option, we have the expertise to customize the procedure to meet all of your child’s medical needs.

We firmly believe that it’s more than just the airway reconstruction operation that gives a child a successful outcome.

Airway reconstructions include procedures involving the area from the top of the voice box to the trachea. Hundreds of procedures fall into two main categories under airway reconstruction:

• Open airway procedures – made with a neck incision into the airway
• Endoscopic procedures (such as microscopic laryngoscopy, bronchoscopy and esophagoscopy) – done through the mouth, limiting the need for an incision in the neck.

At Cincinnati Children's, we perform airway reconstructions for children with breathing difficulties due to congenital defects or as a result of medical procedures. Candidates for airway reconstruction include:

• Children with tracheal or laryngeal problems, including complete tracheal rings and tracheomalacia.
• Babies born prematurely with a history of intubation
• Children with conditions such as glottic stenosis, subglottic stenosis, tracheal stenosis, laryngeal cleft and laryngeal atresia
• A child who has had his / her tracheotomy tube removed

Airway reconstructions are performed on children with breathing difficulties resulting from congenital defects, external injury or medical procedures, and who are experiencing:

• Glottic / Subglottic Stenosis
• Tracheal stenosis
• Laryngeal atresia
• Laryngeal Cleft
• Vocal Cord Paralysis - Unilateral and Bilateral
• Tracheomalacia
• Laryngomalacia
• Tracheal web
• Tracheal Rings
• Stridor (Noisy Breathing)
• Saccular Cysts
• Subglottic Cysts

The four most common types of open airway reconstruction procedures include:

• Laryngotracheal reconstruction (SSLTR) with cartilage grafting
• Cricotracheal resection (CTR)
• Tracheal resection
• Slide tracheoplasty

These procedures either reconstruct or expand segments of the airway, depending on the child’s unique needs.

At Cincinnati Children’s Hospital Medical Center, we take a holistic approach to assessing and diagnosing our patients. Instead of sending your child to various doctor appointments and diagnostic tests spanning weeks − or even months − we try to perform all exams and tests within a few days.

Our integrated approach allows doctors in multiple disciplines to work together to determine the best course of action for your child. Often, children have a variety of medical issues that need to be addressed, and our team provides coordinated care for each child. Your child’s needs are discussed with you and your family, leading to an integrated, customized treatment plan.

In addition to dedicated surgeons and physicians, we provide excellent peri-operative and post-operative care, from anesthesia and the Intensive Care Unit, to swallowing and voice rehabilitation. We ensure that each child receives the care she needs, for as long as she needs it. When your child is a patient at Cincinnati Children’s, you receive the benefit of not just one doctor’s opinion, but an entire community of doctors all striving for a positive outcome.

 The Center for Pediatric Voice Disorders at Cincinnati Children’s is a world-class source for diagnosis and treatment of disorders of the larynx (voice box). Otolaryngologists, speech-language pathologists and nurses are all part of the team who work closely with you, your child and your family to develop an individualized care for the patient.

Learn more about the Center for Pediatric Voice Disorders.