Surgeons Describe Single-Stage Laryngotracheal Reconstruction

CHOP airway surgeons describe laryngotracheal reconstruction. This complex surgery, sometimes called laryngotracheoplasty, enlarges a narrowed airway by opening a scarred area and placing cartilage grafts in the openings to widen the diameter of the airway.


Surgeons Describe Single-Stage Laryngotracheal Reconstruction

Ian N. Jacobs, MD: Laryngotracheal reconstruction, or LTR, involves reconstruction using cartilage grafts to expand or enlarge the airway. These cartilage grafts are borrowed from the rib. So cartilage can be easily transplanted from one portion of the body to the other and will survive in a remarkable fashion. And what it's used as is a spacer. In other words, it enlarges the size of the airway.

Karen B. Zur, MD: We're going to be splitting up the cricoid cartilage and the trachea in the midline and then importing a piece of rib cartilage. Or it could be another type of cartilage, but most commonly a rib cartilage. The piece of graft is shaped to fit that defect and then it gets snapped into the area between those split ends of the cricoid. 

Ian N. Jacobs, MD: We take a very narrowed airway and we'll transect that airway in one or two positions and place one of these spacers in there to dramatically enlarge the size of the airway. 

Mother: The cartilage, actually, he said, just went beautifully into her airway. 

Father: And where they had done the graft, you could see that new tissue was growing around the graft. 

Mother: And the cartilage is now just going to become part of her airway. And eventually when you go down there with another scope, you won't even see it.

Related Centers and Programs: Center for Pediatric Airway Disorders