"Laryngotracheal Reconstruction in Adults Aged 60 Years and Older" by Saad C. Rehman, Deborah X. Xie et al.
 

Laryngotracheal Reconstruction in Adults Aged 60 Years and Older

Document Type

Article

Abstract

OBJECTIVE: The primary aim of this study is to evaluate the safety, efficacy, and execution of major open laryngotracheal operations for patients in the advanced decades. STUDY DESIGN: Case series with chart review. SETTING: Multidisciplinary clinic at a tertiary care academic hospital. SUBJECTS AND METHODS: Patient characteristics, operative course, and postoperative outcomes were retrospectively recorded for all airway reconstruction operations performed between 1999 and 2016 on patients aged =60 years Long-term success was defined as prosthesis-free survival at last follow-up. Descriptive statistics were performed. RESULTS: Twenty-nine patients met inclusion criteria, and the median age was 71 years (interquartile range, 63-74). Tracheal resection was the most common procedure (13 patients), followed by laryngotracheal reconstruction (7 patients). Fifteen patients began their operation with a tracheostomy, 6 of whom underwent decannulation prior to leaving the operating room. Three additional patients underwent decannulation at follow-up appointments and were prosthesis-free at most recent follow-up. The mean time to decannulation among these patients was 3 months. Of the 14 patients beginning their procedure without a tracheostomy, only 2 required permanent airway prosthesis. The overall long-term rate of prosthesis-free survival was 72.4% (21 of 29 patients). Factors suggestive of long-term success include lower McCaffrey grade and lack of pulmonary disease, hypertension, or diabetes, as well as decreased red blood cell distribution width on preoperative complete blood count. CONCLUSION: Through careful patient selection, preoperative workup, and meticulous postoperative care, airway reconstruction procedures in patients aged =60 years are reasonably successful. Of 29 patients, 21 (72.4%) were successfully breathing long-term without airway prosthesis.

Medical Subject Headings

Age Factors; Aged; Aged, 80 and over; Female; Humans; Laryngostenosis (surgery); Male; Middle Aged; Plastic Surgery Procedures; Retrospective Studies; Tracheal Stenosis (surgery); Tracheostomy; Treatment Outcome

Publication Date

6-1-2019

Publication Title

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

E-ISSN

1097-6817

Volume

160

Issue

6

First Page

1065

Last Page

1070

PubMed ID

30717620

Digital Object Identifier (DOI)

10.1177/0194599818825471

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