{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T02:32:22Z","timestamp":1768703542738,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T00:00:00Z","timestamp":1614297600000},"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":[[2021,9]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To identify any potential barriers for decannulation in children undergoing double\u2010staged laryngotracheal reconstruction (dsLTR) beyond the severity of disease itself.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective chart review from 2008 to 2018 of 41 children who had undergone dsLTR as primary treatment for laryngotracheal stenosis at a stand\u2010alone tertiary children's hospital. We examined the effect of demographic, medical, and surgical factors on successful decannulation and time to decannulation after dsLTR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 41 children meeting inclusion criteria who underwent dsLTR, 34 (82%) were decannulated. Age, gender, race, insurance status, medical comorbidity, and multilevel stenosis did not predict overall decannulation. Insurance status did not impact time to decannulation (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.13, Log\u2010rank). Factors that increased length of time to decannulation were the use of anterior and posterior cartilage grafts (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001, Log\u2010rank), history of pulmonary disease (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.05, Log rank), history of cardiac disease (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.017, Log\u2010rank), and race\/ethnicity (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.001 Log\u2010rank).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a cohort with a similar decannulation rates to previous dsLTR cohorts, we identified no demographic or medical factors that influenced overall decannulation. We did observe that pulmonary comorbidity, cardiac comorbidity, and race\/ethnicity lengthens time to decannulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:2141\u20132147, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29486","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T16:25:10Z","timestamp":1614356710000},"page":"2141-2147","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Barriers to Decannulation After Double\u2010Stage Laryngotracheal Reconstruction"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8104-4851","authenticated-orcid":false,"given":"Maria B.","family":"Koenigs","sequence":"first","affiliation":[{"name":"Division of Pediatric Otolaryngology Children's National Hospital  Washington District of Columbia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0050-8336","authenticated-orcid":false,"given":"Hengameh K.","family":"Behzadpour","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Children's National Hospital  Washington District of Columbia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George H.","family":"Zalzal","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Children's National Hospital  Washington District of Columbia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0075-8279","authenticated-orcid":false,"given":"Diego A.","family":"Preciado","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Children's National Hospital  Washington District of Columbia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"475","article-title":"Surgical correction of subglottic stenosis of the larynx. 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