Complete tracheal rings refers to a defect in the structure of the cartilages that make up the trachea. Normal tracheal anatomy consists of cartilage rings which are horseshoe shaped, allowing the airway to have flexibility when breathing in and out. Complete tracheal rings are circular and tend to result in a much smaller airway than a normal trachea. This abnormality often accompanies certain heart and large blood vessel abnormalities, like a pulmonary sling.
The tracheal reconstruction team at Lurie Children’s is comprised of surgeons from two divisions – Cardiovascular-Thoracic Surgery and Otolaryngology (ENT)’s Aerodigestive Program.
Often, diagnosis of tracheal defect is made by the ENT team, and when surgical repair within the chest is necessary, the cardiothoracic surgeons work as a team with surgeons from ENT to correct these defects. Surgeons use many materials (patient’s own tissue, manufactured grafts) and techniques to perform this surgery, which require the use of cardiopulmonary bypass.
Why Choose Lurie Children's?
Our cardiothoracic surgeons at Lurie Children’s are board-certified thoracic surgeons (surgeons who operate on the chest and its organs – lungs, heart). They perform tracheal reconstructions using cardiopulmonary bypass, which allows the patient’s heart and lungs to be oxygenated while the airway is being repaired.
Our board-certified ENT surgeons utilize specialized instruments and tools tailored specifically for use in infants and children. Postoperatively, our ENT surgeons perform bronchoscopies (insert a thin, lighted tube down the throat into the windpipe and airways) to assess healing and whether the narrowed area(s) are open.
Additionally, our Medical Imaging team uses advanced scanning techniques to help the surgeons see the defect location and extent before surgery, to help in planning the best operative procedure for the patient. After surgery, the team assesses whether the repair was successful in widening the narrowed area of the trachea.
The collaboration among Otolaryngology, Cardiovascular-Thoracic Surgery, and Medical Imaging teams provides diagnosis and definitive treatment for this rare condition.
Lurie Children’s first operated on a child for tracheal reconstruction in 1982. Since its beginnings more than 40 years ago, we have been operating on approximately 25 infants and children with severe tracheal defects a year.
Depending on the length and severity of the narrowing or damage, we have used several techniques:
- Pericardial tracheoplasty
- Resection (excision of the narrowing) with end-to-end anastomosis (bringing together the cut ends of the trachea)
- Autograft tracheoplasty (using a section of the child’s own trachea as a patch)
- Slide tracheoplasty, which is the method most used now.
After surgery, patients are assessed by our Otolaryngology team for long-term follow-up care.
Conditions We Treat
- Complete tracheal rings
- Tracheal stenosis (narrowing) due to damage from causes such as accidents, tumors, ingestion of damaging agents
What to Expect
Your primary care physician may initially contact our ENT surgeons for diagnosis if symptoms are not severe and do not require hospital admission. Diagnostic workup can then be done on an elective basis under the ENT surgeons’ direction.
Occasionally, a diagnosis has already been made, and your child will need to be treated surgically at Lurie Children’s. In that case, your physician often will contact either the ENT or cardiovascular-thoracic surgeons directly to refer your child to our program – either through transfer to Lurie Children’s if your child is hospitalized, or to arrange for assessment and follow-up on a non-emergency, elective basis.
Our Specialists
Cardiothoracic Surgeons
Our three attending surgeons are American Board of Thoracic Surgery-certified Thoracic and Congenital Cardiac Surgeons. They have expertise in all aspects of tracheal reconstruction surgery.
David S. Winlaw, MD, FRACS
Division Head, Cardiovascular-Thoracic Surgery; Co-Executive Director, Heart Center; Willis J. Potts, MD Founders’ Board Professorship in Surgery
Michael C. Mongé, MD
Surgical Director, Heart Failure/Heart Transplant Program; Attending Physician, Cardiovascular-Thoracic Surgery
Otolaryngologists (ENT)
Dana M. Thompson, MD, MS, MBA, FACS
Division Head, Otorhinolaryngology-Head & Neck Surgery; Lauren D. Holinger, MD Professorship in Pediatric Otolaryngology; Executive Physician Director, Ambulatory Practice
Jonathan B. Ida, MD, MBA, FACS
Attending Physician, Otorhinolaryngology-Head & Neck Surgery
Jennifer M. Lavin, MD, MS
Attending Physician, Otorhinolaryngology-Head & Neck Surgery; Director of Quality and Safety
Taher Valika, MD
Attending Physician, Otorhinolaryngology-Head & Neck Surgery; Medical Director, Aerodigestive Program
Make an Appointment
Call to make an appointment with our specialists.
Our Location
Ann & Robert H. Lurie Children's Hospital of Chicago
225 E. Chicago Ave.Chicago, Illinois 60611
312.227.4000