{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T18:49:30Z","timestamp":1782154170261,"version":"3.54.5"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T00:00:00Z","timestamp":1599609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005762","name":"National Taiwan University Hospital","doi-asserted-by":"publisher","award":["109\u2010N03"],"award-info":[{"award-number":["109\u2010N03"]}],"id":[{"id":"10.13039\/501100005762","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Our objective was to gather data that would enable us to suggest more specific guidelines for the management of children with airway disruption.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case series with data from five tertiary medical centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children younger than 18\u2009years of age with a disrupted airway were enrolled in this series. Data pertaining to age, sex, etiology and location of the disruption, type of injury, previous surgery, presence of air extravasation, management, and outcome were obtained and summarized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty children with a mean age of 4.4\u2009years (range 1\u2009day\u201314.75\u2009years) were included in the study. All were evaluated by flexible endoscopy and\/or microlaryngoscopy in the operating room. Twelve (60%) children had tracheal involvement; seven had bronchial involvement; and one had involvement of the cricoid cartilage. Nine children had air extravasation, and all these children required surgical repair. Of the 11 who did not have air extravasation, only one underwent surgical repair. Complete healing of the disrupted airway was seen in all cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This series suggests that if there is no continuous air extravasation demonstrated on imaging studies or clinical examination, nonoperative management may allow for spontaneous healing without sequelae. However, surgical repair may be considered in those patients with continuous air extravasation unless a cuffed tube can be placed distal to the site of injury. For children in whom airway injury occurs in a previously operated area, the risk of extravasation is reduced. This risk is also diminished if positive pressure ventilation can be avoided or minimized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:921\u2013924, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29051","type":"journal-article","created":{"date-parts":[[2020,9,28]],"date-time":"2020-09-28T22:02:29Z","timestamp":1601330549000},"page":"921-924","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Management of the Disrupted Airway in Children"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8583-8459","authenticated-orcid":false,"given":"Wei\u2010Chung","family":"Hsu","sequence":"first","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."},{"name":"Division of Pediatric Otolaryngology, Department of Otolaryngology National Taiwan University College of Medicine and National Taiwan University Hospital and Children's Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Schweiger","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."},{"name":"Department of Otolaryngology Hospital de Clinicas  Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0670-9937","authenticated-orcid":false,"given":"Catherine K.","family":"Hart","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Cincinnati, College of Medicine  Cincinnati Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6593-9559","authenticated-orcid":false,"given":"Matthew","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricio","family":"Varela","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Clinica Las Condes and Hospital de Ni\u00f1os Calvo McKenna and University of Santiago  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery (Servicio Cirugia Pediatrica) Hospital Universitario La Fe  Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Ormaechea","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Hospital Pereira Rossell  Montevideo Uruguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliza P.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Rutter","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery Cincinnati Children's Hospital Medical Center  Cincinnati Ohio U.S.A."},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Cincinnati, College of Medicine  Cincinnati Ohio 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