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Factors affecting graft healing in laryngotracheal reconstruction: a retrospective single-center experience

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To examine the factors that affect graft healing after laryngotracheal reconstruction (LTR).

Methods

We conducted a retrospective chart review at King Abdulaziz University Hospital, Riyadh, Saudi Arabia, between January-2008 and October-2023. We included all patients who underwent LTR and required anterior and/or posterior graft placement, while those who underwent procedures without graft placement and those with incomplete information were excluded.

Results

Forty-nine patients were analyzed. Most patients were pediatric (65.3%), male (65.3%), had no coexisting comorbidities (55.1%), and harbored grade 3–4 stenosis (59.2%). Thirty patients (61.2%) underwent open surgery. Various graft complications occurred including infection (n = 1, 2%), dehiscence (n = 3, 6.1%), scar (n = 6, 12.2%), and granulation (n = 29, 59.2%). Only 15 patients (30.65%) achieved the composite status of “healthy” graft. Among 43 patients who had postoperative cultures, positive results for Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus were observed in 10 and four patients, respectively. Open surgery and double-stage procedure were significantly associated with higher rates of granulation tissue formation. Pediatric-age group had significantly higher rate of complete epithelization compared to adult-age group. A significantly greater proportion of patients who had unhealthy grafts had open surgery. The rate of double-stage LTR was significantly higher in unhealthy grafts compared to healthy grafts. Prolonged stent duration was linked to various graft-related complications. Multivariate logistic regression analyses showed no statistically significant correlations between various factors and postoperative graft-related complications.

Conclusion

Open surgery, double-stage procedure, pediatric age group, and stent duration were not significant risk factors associated with postoperative graft-related complications during LTR in multivariate analysis.

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Funding

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Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, King Saud University Medical City, Riyadh, Saudi Arabia

    Abdullah Sindi, Fatima S. Alangari, Nasser Almutairi, Abdulah Aljasser & Ahmed Alammar

  2. Department of Otolaryngology, King Abdullah Medical Complex, Jeddah, Saudi Arabia

    Abdullah Sindi

  3. College of Medicine, Alfaisal University, Riyadh, Saudi Arabia

    Yara Akkielah & Nasser Almutairi

  4. Department of Otolaryngology-Head and Neck Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

    Nasser Almutairi

Authors
  1. Abdullah Sindi
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  2. Fatima S. Alangari
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  3. Yara Akkielah
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  4. Nasser Almutairi
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  5. Abdulah Aljasser
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Contributions

Abdullah Sindi contributed to study conception, study design, data collection, data analysis, and manuscript writing. Fatima S. Alangari, Yara Akkielah, Nasser Almutairi, and Abdulah Aljasser contributed to literature review, data collection, and revision of manuscript for editorial and intellectual contents. Ahmed Alammar contributed to study supervision, study conception, data interpretation, and revision of manuscript for editorial and intellectual contents. All authors read and approved the final draft of manuscript.

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Correspondence to Abdullah Sindi.

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All authors report no conflict of interest.

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Institutional Review Board at King Khaled University Hospital, Riyadh, Saudi Arabia (registration code: E-23-7678).

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Sindi, A., Alangari, F.S., Akkielah, Y. et al. Factors affecting graft healing in laryngotracheal reconstruction: a retrospective single-center experience. Eur Arch Otorhinolaryngol 281, 3083–3093 (2024). https://doi.org/10.1007/s00405-024-08611-2

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  • DOI: https://doi.org/10.1007/s00405-024-08611-2

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