Complex tracheostomy-dependent glottic stenosis with laryngeal fistula following extensive electrical burns of the face and neck: A reconstructive challenge

High-voltage electrical injuries in pediatric patients can cause devastating soft tissue and bony damage. Involvement of the larynx or trachea markedly increases the risk of airway compromise, often necessitating urgent airway intervention in the form of endotracheal intubation or tracheostomy. Long-term tracheostomy dependence further increases the morbidity by compromised glottis function and respiratory infection. The restoration of laryngeal function and decannulation becomes challenging in these cases. Complex multistage reconstruction is often required. We report a complex case of a 10-year-old male who sustained 25% total body surface area burns with full-thickness facial burns, exposed mandible, and a laryngeal fistula. Early tracheostomy was performed, followed by staged surgical management including initial stabilization, serial debridement, mandibular stabilization, airway maintenance, regional flap coverage for soft-tissue reconstruction, and flap for stoma in the anterior wall of the larynx. This report highlights the reconstructive challenges and multidisciplinary care involved in salvaging functional and structural integrity in such a severe pediatric electrical burn injury.