{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T09:51:30Z","timestamp":1777024290819,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T00:00:00Z","timestamp":1693612800000},"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":[[2024,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate how patient characteristics and surgical techniques influence the rate of and time to decannulation after pediatric revision laryngotracheal reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was a retrospective cohort investigation of children with a history of laryngotracheal stenosis treated between 2008 and 2021 with revision open airway surgery. The primary outcome evaluated was decannulation. The secondary outcome analyzed was time to decannulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010nine children were included in the study with median age 49\u2009months; 61.5% were male. Children undergoing single stage revision surgery were far more likely to be decannulated (OR 6.25, 95% CI 1.33\u201345.97, <jats:italic>p<\/jats:italic>\u2009=\u20090.0343). Rolling logistic regression of the probability of decannulation stratified by time between open surgeries demonstrated significantly decreased chance of decannulation with reoperation within 6\u2009months. Children managed with anterior\/posterior grafting compared with a single graft were observed to have an increased time to decannulation, (HR 0.365, 95% CI 0.148\u20130.899, <jats:italic>p<\/jats:italic>\u2009=\u20090.005, Log\u2010Rank).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We observe that in the case of revision pediatric open airway surgery, chance of decannulation is improved when surgery is performed in a single stage as well as 6\u2009months after the most recent procedure. Patients and families should be counseled that complex stenosis requiring double stage procedures or anterior\/posterior grafting is associated with a decreased probability of decannulation and increased postoperative time with a tracheostomy, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 134:1926\u20131932, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30985","type":"journal-article","created":{"date-parts":[[2023,9,2]],"date-time":"2023-09-02T09:19:37Z","timestamp":1693646377000},"page":"1926-1932","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Decannulation in Revision Pediatric Laryngotracheal Reconstruction"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7955-0392","authenticated-orcid":false,"given":"James A.","family":"Leonard","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2010 Head &amp; Neck Surgery MedStar Georgetown University Hospital  Washington DC U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6291-0726","authenticated-orcid":false,"given":"Daniel L.","family":"Blumenthal","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2010 Head &amp; Neck Surgery MedStar Georgetown University Hospital  Washington DC 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":"Department of Pediatric Otolaryngology Children's National Medical Center  U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0636-6233","authenticated-orcid":false,"given":"Claire M.","family":"Lawlor","sequence":"additional","affiliation":[{"name":"Department of Pediatric Otolaryngology Children's National Medical Center  U.S.A."},{"name":"Department of Pediatrics and Surgery George Washington University School of Medicine  Washington DC U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0075-8279","authenticated-orcid":false,"given":"Diego","family":"Preciado","sequence":"additional","affiliation":[{"name":"Department of Pediatric Otolaryngology Children's National Medical Center  U.S.A."},{"name":"Department of Pediatrics and Surgery George Washington University School of Medicine  Washington DC U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,9,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2021.110704"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348947408300402"},{"issue":"6","key":"e_1_2_6_4_1","first-page":"475","article-title":"Surgical correction of subglottic stenosis of the larynx. 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