Evidence map›Paper›PMID 40281312›Full record

SynthesisEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2025

Comparative success of different graft types in pediatric laryngotracheal reconstruction: a systematic review and meta-analysis.

Mohammed A Awadh, Abdulsalam Alqutub, Mohammad A Alzahrani, Naif Mozahim, Sarah M AlSharif, Abeer Z Malebari, Talal Al-Khatib

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. [Clinical practice guidelines for pediatric open laryngotracheoplasty（2026）].Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery · 2026
    Guideline
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mohammed A AwadhDepartment of Otorhinolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
Abdulsalam AlqutubDepartment of Otorhinolaryngology-Head and Neck Surgery, Makkah Health Cluster, Makkah, Saudi Arabia. ksasalam47@gmail.com.ORCID http://orcid.org/0000-0002-8602-4972
Mohammad A AlzahraniDepartment of Otorhinolaryngology-Head and Neck Surgery, Ohud General Hospital, Al Madinah Al Munawwarah, Medina, Saudi Arabia.
Naif MozahimDepartment of Otorhinolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
Sarah M AlSharifDepartment of Otorhinolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
Abeer Z MalebariDepartment of Otorhinolaryngology-Head and Neck Surgery, King Fahad General Hospital, Jeddah, Saudi Arabia.
Talal Al-KhatibDepartment of Otorhinolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLaryngotracheal stenosis (LTS) results from abnormal airway narrowing, primarily caused by iatrogenic injuries like prolonged intubation. It leads to respiratory distress and vocal complications, requiring interventions ranging from endoscopic procedures to open surgeries like laryngotracheal reconstruction (LTR) with autologous grafts. Pediatric patients pose unique challenges due to smaller airways but may have better healing outcomes. This review aims to synthesize evidence on the success and operative parameters of different grafts in pediatric LTR to guide clinical decision-making and improve patient outcomes.

methodsWe retrieved relevant articles from PubMed, Scopus, Web of Science, and the Cochrane Library up to August 2024. Two independent authors extracted data from eligible studies, including baseline information, success rate, need for extra procedures, time to stent removal, and time to decannulation. All analyses were undertaken using RevMan v5.4.

resultsWe collected 1,201 records from four databases after excluding 788 duplicates. After screening titles and abstracts, 108 records were assessed for eligibility, resulting in 86 included articles. Of these, 64 had enough data for analysis. The overall success rate for LTR was 89% for costal grafts, 86% for thyroid grafts, and 85% for auricular grafts, with no significant differences between graft types. A third of cases required additional procedures. Time to stent removal averaged 7.85 days for single-stage LTR and 62.86 days for double-stage LTR. Decannulation took 198.29 days. Complications included respiratory issues like atelectasis and pneumonia, graft-related problems, infections, and wound complications. Donor site complications and deaths were rare but occurred due to respiratory arrest, pneumothorax, and tracheotomy tube obstruction.

conclusionCostal, thyroid, and auricular grafts are comparable and show similar success rates in pediatric LTR. Optimizing perioperative management is crucial for reducing complications. Future research should standardize postoperative care and address patient pathology heterogeneity to improve outcomes.

Indexed as

LaryngostenosisLarynxPlastic Surgery ProceduresTracheaTracheal StenosisChildHumansTreatment OutcomeLaryngoplastyLaryngotracheal reconstructionLaryngotracheal stenosisLaryngotracheoplasty

Identifiers

PMID40281312

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.