Treatment of chronic aspiration secondary to laryngeal stent by endoscopic capping

Maintaining an adequate airway after laryngotracheal reconstruction (LTR) is an important factor in achieving a successful outcome. Intraluminal stenting has long been advocated. The purposes of an intraluminal stent are to hold grafts or flaps in position, to support the reconstructed but still unstable laryngotracheal framework, and to prevent scar contracture. A polytef (Teflon) stent is commonly used after LTR in the pediatric age group. This hollow stent, introduced initially by Aboulker et al, seems to induce less tissue reaction, while allowing voice and respiration. The hole also aids in easy endoscopic removal of the stent. Usually, the top of the stent must be positioned above the level of the false vocal cords, thus exposing the patient to possible aspiration. In a small number of patients, aspiration may persist, causing significant morbidity. We describe an endoscopic procedure to eliminate postoperative aspiration that fails to resolve with time, by endoscopic capping of the hollow laryngeal stent.