Collection
Pediatric Airway Reconstruction & Stenosis Management
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Surgical Techniques & Outcomes4 items
Airway and Swallowing Outcomes Following Laryngotracheoplasty With Posterior Grafting in Children
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Objectives/Hypothesis: Evaluate swallowing and airway outcomes following laryngotracheoplasty with posterior grafting (LTP PCCG). Methods: Retrospective review of pediatric patients undergoing LTP PCCG from 2016 to 2019 at a tertiary care p
article · Oct 2026
Outcome measures for pediatric laryngotracheal reconstruction: International consensus statement
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Objectives: Develop multidisciplinary and international consensus on patient, disease, procedural, and perioperative factors, as well as key outcome measures and complications, to be reported for pediatric airway reconstruction studies. Met
article · Oct 2026
Short- versus Long-term Stenting in Children with Subglottic Stenosis Undergoing Laryngotracheal Reconstruction
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Objectives Suprastomal stents are routinely used in laryngotracheal reconstruction (LTR) to stabilize grafts and provide framework to sites of repair. However, the duration of stenting varies according to patient history and physician prefe
article · Oct 2026
A multicenter study analyzing the impact of pre-existing comorbidities on laryngotracheal reconstruction (LTR) outcomes.
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Comorbidities such as chronic lung disease and gastroesophageal reflux (GERD), prematurity, and numerous other conditions may impact the success of LTR. Single-center studies are limited in terms of patient numbers and may be underpowered.
article · Oct 2026
Stenting Strategies1 item
Outcomes of Prophylactic Epiglottic Petiole Suspension at the Time of Complete Laryngofissure
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Objectives: To compare the clinical outcomes of patients with prophylactic petiole suspension (PPS) at the time of laryngofissure and patients without PPS. Study Design: Retrospective case series. Setting: Tertiary pediatric hospital from M
article · Oct 2026
Preoperative Assessment1 item
Impedance probe testing prior to pediatric airway reconstruction
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Objective: This study aimed to determine if preoperative impedance testing changed management and if testing was associated with surgical outcome in patients undergoing airway reconstruction. Methods: Retrospective review of patients who ha
article · Oct 2026
Animal Models & Research2 items
In Reference to Establishing an Endoscopic Chronic Subglottic Stenosis Rabbit Model.
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The Laryngoscope · 2023
article · Oct 2026
Establishing an Endoscopic Chronic Subglottic Stenosis Rabbit Model
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Objectives/Hypothesis: To develop a reproducible and consistent chronic subglottic stenosis (SGS) in an endoscopic animal model. Study Design: Prospective study. Methods: We conducted a prospective study using New Zealand white rabbits. Chr
article · Oct 2026
The Cincinnati team has learned not to be afraid of mobilizing the esophagus, which is important for the procedure. — Alessandro de Alarcon, QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon · 2:29
Complete Tracheal Rings4 items
Characteristics and Outcomes of Surgical Treatment for Bronchial Anomalies.
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Bronchial anomalies are rare but challenging conditions to treat in children, encompassing a variety of structural abnormalities that could compromise airway patency. This includes complete rings, absent cartilage, traumatic avulsions, bron
article · Oct 2026
Congenital Absence of Tracheal or Bronchial Rings.
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Congenital airway stenosis secondary to absent tracheal or bronchial rings is a rare congenital anomaly that is difficult to manage both clinically and surgically. This typically manifests as severe segmental tracheomalacia, and only isolat
article · Oct 2026
Growth and Management of Repaired Complete Tracheal Rings after Slide Tracheoplasty.
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This study documents the growth and course of repaired complete tracheal rings over time after slide tracheoplasty. Case series with review. Tertiary pediatric academic medical center. Medical records of pediatric patients with confirmed tr
article · Oct 2026
Unrepaired Complete Tracheal Rings: Natural History and Management Considerations
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Objectives To document the natural growth pattern of unrepaired complete tracheal rings (UCTRs) and describe the patient population managed conservatively. Study Design Case series with chart review. Setting Tertiary pediatric academic cent
article · Oct 2026
Slide Tracheoplasty4 items
Slide tracheoplasty for the treatment of tracheoesophogeal fistulas
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Purpose: The purpose of this study is to determine the surgical outcome of slide tracheoplasty for the treatment of tracheoesophageal (TE) fistula in pediatric patients. Methods: After internal review board approval, the charts of pediatric
article · Oct 2026
Cervical slide tracheoplasty
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Objective: To describe our experience with cervical slide tracheoplasty (CST) in managing complex laryngotracheal disorders. Design: Retrospective analysis. Setting: Quaternary care pediatric institution. Patients: The study included 29 pat
article · Oct 2026
Long-term outcomes of children undergoing slide tracheoplasty: An institutional review of 227 patients
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Objective: Literature on the slide tracheoplasty (STP) is primarily limited to small institutional experiences. Therefore, the authors analyzed their large institutional experience with STP. Methods: All consecutive patients who underwent t
article · Oct 2026
Slide Tracheoplasty for Repair of Complex Tracheoesophageal Fistulas.
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Repair of large, recurrent, and complex tracheoesophageal fistulas (TEFs) is challenging and numerous different surgical approaches exist. These various techniques each carry a set of risks and possible complications such as fistula recurre
article · Oct 2026
Cervical Tracheopexy2 items
Combined cervical and thoracic approach for esophageal atresia with tracheopexy
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Podcast Episode · Stay Current in Pediatric Surgery · 14 December 2023 · 5min
podcast5:26 · Oct 2026
QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon
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Cincinnati Children's hosted the QUAD conference in October 2022 which was a combination of four conferences: The international organization for is Esophageal atresia, the Aerodigestive Society Conference, the Cincinnati Children's Airway c
video5:26 · Dec 2023
Congenital Tracheal Stenosis1 item
International Pediatric Otolaryngology Group (IPOG) consensus recommendations: Evaluation and management of congenital tracheal stenosis
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Objectives: To outline an expert-based consensus of recommendations for the diagnosis and management of pediatric patients with congenital tracheal stenosis. Methods: Expert opinions were sought from members of the International Pediatric O
article · Oct 2026
Differences in Flexible and Rigid Bronchoscopy for Assessment of Tracheomalacia
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Objectives/Hypothesis: Both flexible and rigid bronchoscopy can be used to assess tracheomalacia; however, there is limited evidence comparing the two techniques. The objective of this study was to compare flexible and rigid bronchoscopy fo
article · Oct 2026
Ultrashort Echo-Time MRI for the Assessment of Tracheomalacia in Neonates
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Background: Bronchoscopy is the gold standard for evaluating tracheomalacia; however, reliance on an invasive procedure limits understanding of normal airway dynamics. Self-gated ultrashort echo-time MRI (UTE MRI) can assess tracheal dynami
article · Oct 2026
Management of A-Frame Tracheal Deformity in Children With Endoscopic Resection Tracheoplasty.
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Tracheal A-frame deformity is a known consequence of tracheostomy that may lead to obstruction after decannulation. The goal of this study is to demonstrate the feasibility and success of endoscopic carbon dioxide (CO2 ) laser-assisted trac
article · Oct 2026
Tracheal A-Frame Deformities Following Airway Reconstruction
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Objectives: Airway reconstruction for subglottic and tracheal stenosis is often successful in achieving tracheostomy decannulation and improving airway symptoms. However, one common reason for late failure is development of a tracheal A-fra
article · Oct 2026
Pilot Study to Assess the Use of Ultrasound in Evaluating the Abnormal Pediatric Airway
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In this study, we sought to explore the feasibility of using ultrasonography to evaluate airway anomalies in awake children with previous airway reconstruction. For the month of December 2018, we reviewed the medical records of patients age
article · Oct 2026
About one-third of children with tracheostomies screened at Cincinnati Children's are colonized with MRSA. — Alessandro de Alarcon, Screening and treatment of MRSA colonization in pediatric airway surgery patients · 5:19
Cervical slide tracheoplasty in adults with laryngotracheal stenosis
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Objectives: 1) Evaluate success rates for adults undergoing cervical slide tracheoplasty. 2) Examine complication rates of slide tracheoplasty in adults. Methods: A retrospective cohort of adults > 21 years of age undergoing cervical slide
article · Oct 2026
Revision thoracic slide tracheoplasty: Outcomes following unsuccessful tracheal reconstruction.
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Over the past decade, thoracic slide tracheoplasty (TST) has become the principal operation in the management of congenital tracheal stenosis. The purpose of this report was to describe our experience with revision TST following unsuccessfu
article · Oct 2026
Facial Palsy Following Embolization of a Juvenile Nasopharyngeal Angiofibroma
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Objectives: To describe a case of the rare complication of facial palsy following preoperative embolization of a juvenile nasopharyngeal angiofibroma (JNA). To illustrate the vascular supply to the facial nerve and as a result, highlight th
article · Oct 2026
Temporal Segmentation for Laryngeal High-Speed Videoendoscopy in Connected Speech
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Objective: This study proposes a gradient-based method for temporal segmentation of laryngeal high-speed videoendoscopy (HSV) data obtained during connected speech. Methods: A custom-developed HSV system coupled with a flexible fiberoptic n
article · Oct 2026
Interdisciplinary approach to esophageal replacement and major airway reconstruction.
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Severe esophageal disease warranting replacement often presents with additional airway anomalies in children. Colon interposition and airway reconstruction have separately proven successful in attaining satisfactory outcomes. The aim of thi
article · Oct 2026
Experimental Investigation on Minimum Frame Rate Requirements of High-Speed Videoendoscopy for Clinical Voice Assessment
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This study investigated the impact of high-speed videoendoscopy (HSV) frame rates on the assessment of nine clinically-relevant vocal-fold vibratory features. Fourteen adult patients with voice disorder and 14 adult normal controls were rec
article · Oct 2026
The nasogastric tube syndrome in infants
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This series of three patients is the first description of the presentation, clinical course, and endoscopic findings of nasogastric tube-related airway distress, or nasogastric tube syndrome, in infants. We identify key differences in disea
article · Oct 2026
Voice outcomes following adult cricotracheal resection.
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Cricotracheal resection (CTR) is an effective treatment for moderate-to-severe laryngotracheal stenosis (LTS) in adults. However, one of the potentially significant sequela of this procedure is postoperative dysphonia and permanent voice al
article · Oct 2026
Endoscopic airway management in children
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Purpose Of Review: To discuss the current status of endoscopic airway surgery in children. Recent Findings: More refined endoscopic instruments have been introduced, including balloon dilators, powered debriders, lasers with more exact mode
article · Oct 2026
Controversies in aural atresia repair
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Purpose Of Review: To discuss recent controversies regarding the management of aural atresia. Recent Findings: Management of unilateral atresia is less controversial. Candidacy for successful repair is based on high-resolution computed tomo
article · Oct 2026
Screening and treatment of MRSA colonization in pediatric airway surgery patients
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Interview with Alessandro de Alarcon, MD, MPH, author of Screening and Treatment of Methicillin-Resistant Staphylococcus aureus in Children Undergoing Open Airw
podcast8:21 · Oct 2026
Patient and Family Resources
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Patient and Family Resources | Cincinnati Children's Schedule an Appointment Directions International Billing Sign in to MyChart Ways to Help Donate Now Navigation Patients and Families Patients and Family Home Schedule an Appointment Servi
article · Oct 2026
Resources for Healthcare Professionals
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Resources for Healthcare Professionals Schedule an Appointment Directions International Billing Sign in to MyChart Ways to Help Donate Now Navigation Patients and Families Patients and Family Home Schedule an Appointment Services and Specia
article · Oct 2026
Researchers, Cincinnati Children's Hospital Medical Center
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We believe in science and compassion. Learn how our scientists conduct breakthrough research to improve the lives of children every day.
article · Oct 2026
Support Services | Cincinnati Children's Research Foundation
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Support services help design grant proposals, manage data, comply with regulations, protect intellectual property and assist with commercialization. Read more.
article · Oct 2026
Research
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Pediatric otolaryngology combines the latest in state-of-the-art technology and facilities with unsurpassed knowledge of otolaryngology care. Learn more.
article · Oct 2026
Newsroom
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Cincinnati Children’s is dedicated to keeping families, healthcare professionals, and the news media informed with the latest updates, discoveries, and institutional milestones.
article · Oct 2026
Pdf Non Discrimination Statement.Pdf
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article · Oct 2026
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QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon
Cincinnati Children's typically uses a combined cervical and thoracic approach for esophageal atresia cases.
clinicalAlessandro de Alarcon0:49 ↗
Preoperative testing includes dynamic CT imaging, pulmonary function tests, microlaryngoscopy and bronchoscopy, and flexible bronchoscopy.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position0:55 ↗
Required intraoperative equipment includes a neck tray, MLB tray, and Maloney dilators or NG tubes.
clinicalAlessandro de Alarcon1:15 ↗
Flexible bronchoscopy during the operation is key, and endotracheal tube placement must allow visualization during the procedure.
clinicalAlessandro de Alarcon1:21 ↗
Nasotracheal intubation is often used with the cuff positioned high, sometimes almost at the glottis.
clinicalAlessandro de Alarcon1:29 ↗
A NIM tube is preferred when possible to prevent injury to recurrent nerves or provide awareness when approaching them.
clinicalAlessandro de Alarcon1:39 ↗
The surgical approach uses subplatysmal flaps and addresses anterior compression as needed.
clinicalAlessandro de Alarcon1:55 ↗
The cervical approach can assist thoracoscopic procedures by removing residual or regrown large thymus tissue.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position2:01 ↗
Aortopexy and innominate artery pexy can be added at the same time as the cervical procedure.
clinicalAlessandro de Alarcon2:09 ↗
In the lateral approach, the surgical team works on the side of the airway to find the esophagus.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position2:19 ↗
Pediatric surgeons identify the recurrent nerve for the ENT team to help prevent injury.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position2:23 ↗
The Cincinnati team has learned not to be afraid of mobilizing the esophagus, which is important for the procedure.
opinionAlessandro de Alarcon2:29 ↗
The esophagus is mobilized above the level where the team aims to perform the pexy, making suture placement easier.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position2:43 ↗
Stitches are sometimes placed in the trachea to pull it up and out of the way for visualization of the posterior aspect and spine.
clinicalAlessandro de Alarcon2:54 ↗
A pulmonologist assists with flexible endoscopy through the endotracheal tube to visualize inside the trachea while stitches are placed.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position3:02 ↗
The team uses 3-0 prolene sutures and places all stitches before securing them down.
clinicalAlessandro de Alarcon3:15 ↗
Suture placement is performed under spontaneous ventilation conditions.
clinicalAlessandro de Alarcon3:15 ↗
The combined approach is valuable for complicated cases or patients needing additional operations for symptom relief.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position3:24 ↗
A patient who had prior thoracoscopic tracheopexy with dysphagia from torqued esophagus underwent the combined approach and became symptom-free.
clinicalAlessandro de Alarcon3:33 ↗
Outcome measures include follow-up endoscopy, pulmonary function tests when patients are old enough, and imaging.
clinicalAlessandro de Alarcon4:00 ↗
At 36 months follow-up, imaging may still show tracheomalacia, but patients can be symptomatically better.
clinicalAlessandro de Alarcon4:09 ↗
The team is still learning what measures should define good versus bad outcomes.
opinionAlessandro de Alarcon4:15 ↗
Managing complications including swallowing dysfunction and vocal fold paralysis is part of postoperative care.
clinicalAlessandro de Alarcon4:26 ↗
Otolaryngology involvement is important both during the procedure and in follow-up due to potential complications.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position4:32 ↗
Combined cervical and thoracic approach for esophageal atresia with tracheopexy
Cincinnati Children's typically uses a combined cervical and thoracic approach for esophageal atresia cases.
clinicalAlessandro de Alarcon0:49 ↗
Preoperative testing includes dynamic CT imaging, pulmonary function tests, microlaryngoscopy and bronchoscopy, and flexible bronchoscopy.
Host summaryTodd Ponsky summarizes what Dr. Alessandro de Alarcon said — not the host's own clinical position1:00 ↗
Required intraoperative equipment includes a neck tray, MLB tray, and Maloney dilators versus NG tubes.
clinicalAlessandro de Alarcon1:15 ↗
Flexible bronchoscopy during the operation is key, with the endotracheal tube placed exactly where needed for visualization.
clinicalAlessandro de Alarcon1:21 ↗
Nasotracheal intubation is often used with the cuff positioned very high, sometimes almost at the glottis.
clinicalAlessandro de Alarcon1:29 ↗
A NIM tube is used when possible to prevent potential injury to recurrent nerves or provide awareness when getting close to them.
clinicalAlessandro de Alarcon1:39 ↗
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