A Strategy to Prevent Tracheo-Innominate Artery Fistula in the Course of Laryngotracheal Separation: 9-Year Experience in a Children's Hospital

Nine-year retrospective study of 57 pediatric patients demonstrates that laryngotracheal separation with strategic tracheostomy placement and prophylactic innominate artery management achieves high success rates (94.7% survival) with minimal TIAF risk (1.8%). Technique variations based on pre-existing tracheostomy status allow safe definitive treatment of intractable aspiration in neurologically impaired children.