{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T13:48:12Z","timestamp":1776865692974,"version":"3.51.2"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T00:00:00Z","timestamp":1612569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The present study analyzed surgical outcomes of laryngotracheal separation (LTS) in children with neurological disorders. The purpose of this study was to investigate respiratory impairment and severe complications after LTS in children, and identify the possibility of permanent tracheostomy without a tracheostomy tube as the safest respiratory management method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010eight patients (male:female = 16:12) with neurological disorders (6\u2009months to 32\u2009years) who underwent LTS between January 2012 and April 2018 were reviewed. Tracheal diameter, Cobb angle, and sternocervical spine distance (SCD) were measured to assess the potential risk and possibility of removing tracheostomy tube management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Tracheostomy tube could be removed shortly after LTS in 57% (16\/28). However, nine of these patients developed respiratory problems that required tracheostomy tube placement 2\u2009years after LTS. New requirements for a tracheostomy tube as a stent were strongly correlated with SCD (<jats:italic>P<\/jats:italic> &lt;\u2009.05, odds ratio\u2009&gt;\u20091) as well as tracheal deformity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Respiratory management in neurologically impaired children after LTS without a tracheostomy tube is challenging because thoracic deformity during physical growth affects tracheal disfiguration. Thoracic deformities and progression of scoliosis should be considered in respiratory management approaches in children with neurological disorders, and long\u2010term follow\u2010up by computed tomography is necessary.<\/jats:p><\/jats:sec><jats:sec><jats:title>LEVEL OF EVIDENCE<\/jats:title><jats:p>IV<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.534","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T18:19:18Z","timestamp":1612808358000},"page":"332-339","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Challenge for management without tracheostomy tube after laryngo\u2010tracheal separation in children with neurological disorders"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7231-1658","authenticated-orcid":false,"given":"Noriko","family":"Morimoto","sequence":"first","affiliation":[{"name":"Department of Otolaryngology National Center for Child Health and Development  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanobu","family":"Maekawa","sequence":"additional","affiliation":[{"name":"Department of General Pediatrics and Interdisciplinary medicine National Center for Child Health and Development  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaya","family":"Kubota","sequence":"additional","affiliation":[{"name":"Department of Neurology National Center for Child Health and Development  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Department of Radiology National Center for Child Health and Development  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nozomi","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology National Center for Child Health and Development  Tokyo 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