{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T21:35:19Z","timestamp":1771018519362,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T00:00:00Z","timestamp":1595548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Tracheal A\u2010frame 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 (CO<jats:sub>2<\/jats:sub>) laser\u2010assisted tracheoplasty of tracheal A\u2010frame deformity in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective case series of symptomatic children with tracheal A\u2010frame deformity with no other site of airway obstruction (2016\u20132018). All patients underwent CO<jats:sub>2<\/jats:sub>\u2010laser assisted endoscopic resection tracheoplasty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eight patients (six male) were included with a median age of 15.4 (IQR 12.3\u201317.9) years. Patients had a median of two previous open airway surgeries (IQR 1\u20132.5) and all patients had a history of tracheostomy with successful decannulation. Tracheal A\u2010frame deformity presented as dyspnea on exertion for all patients (n = 8, 100%). Obstructive sleep apnea was confirmed for all patients who underwent polysomnography (4\/4, 100%). Median interval from decannulation to development of symptoms was 8.7\u2009years (IQR 5.8\u20139.3). All patients sized with an age\u2010appropriate endotracheal tube despite the deformity. Endoscopic A\u2010frame tracheoplasty was successful for 7\/8 (87.5%) patients and was performed with overnight observation for these patients (8\/8, 100%). Unilateral A\u2010frame tracheoplasty was performed successfully for five patients (62.5%), bilateral A\u2010frame tracheoplasty was performed successfully for two patients (25.0%), and one patient (12.5%) did not have complete resolution of symptoms after bilateral A\u2010frame tracheoplasty due to multi\u2010level airway obstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CO<jats:sub>2<\/jats:sub> laser\u2010assisted tracheoplasty is an innovative endoscopic technique to relieve symptoms of airway obstruction for selected patients with tracheal A\u2010frame deformity although avoiding the morbidity and hospital stay duration associated with tracheal resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:E719\u2013E723, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28953","type":"journal-article","created":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T15:36:19Z","timestamp":1595604979000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Management of <scp>A\u2010Frame<\/scp> Tracheal Deformity in Children With Endoscopic Resection Tracheoplasty"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8300-3220","authenticated-orcid":false,"given":"Mathieu","family":"Bergeron","sequence":"first","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2010Head and Neck Surgery CHU Ste\u2010Justine  Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Qualls","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2010Head and Neck Surgery Colombia Surgical Specialists  Spokane Washington U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4792-4676","authenticated-orcid":false,"given":"Alessandro","family":"de Alarcon","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2010Head and Neck Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Cincinnati College of Medicine  Cincinnati Ohio U.S.A."},{"name":"Aerodigestive and Esophageal Center Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2257-0605","authenticated-orcid":false,"given":"Michael J.","family":"Rutter","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2010Head and Neck Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Cincinnati College of Medicine  Cincinnati Ohio U.S.A."},{"name":"Aerodigestive and Esophageal Center Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.08.060"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2016.11.74"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4471-4619-3_241"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23945"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2007.01551.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318050ca12"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.127.3.879"},{"key":"e_1_2_6_9_1","unstructured":"KennedyAA deAlarconA MyerIVCM et al. 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