International Journal of Phonosurgery & Laryngology

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VOLUME 2 , ISSUE 1 ( January-June, 2012 ) > List of Articles

RESEARCH ARTICLE

Outcomes in Management of Pediatric Laryngotracheal Stenosis: Our Experience

Mohan Kameswaran, Kiran Natarajan, Arpana Shekhar, Raghunandhan Sampath, Sathya Murali

Citation Information : Kameswaran M, Natarajan K, Shekhar A, Sampath R, Murali S. Outcomes in Management of Pediatric Laryngotracheal Stenosis: Our Experience. Int J Phonosurg Laryngol 2012; 2 (1):14-19.

DOI: 10.5005/jp-journals-10023-1028

Published Online: 01-06-2015

Copyright Statement:  Copyright © 2012; The Author(s).


Abstract

Background

Pediatric laryngotracheal stenosis is a difficult entity encountered in clinical practice which manifests with a myriad of etiologies and presentations. Management of pediatric laryngotracheal stenosis is a surgical challenge which requires meticulous preoperative evaluation and planning.

Aim of study

This is a retrospective study of the efficacy of different surgical techniques involved in restoring the airway patency in pediatric laryngotracheal stenosis performed at our institution over 4 years.

Materials and methods

Twenty-four pediatric patients underwent treatment for laryngotracheal stenosis over a 4-year period (June 2006-May 2010). Various surgical modalities, such as anterior cricoid split, costal cartilage interposition, stenting, laser procedures, etc. were used. Hood's stent, Montgomery T-tube, silastic swiss roll, indwelling nitinol tracheal stent were used to stent the airway after resection of the stenotic segment.

Results

Nine patients achieved successful decannulation with single-stage procedure and 14 patients underwent multiple procedures. Of 24 patients, decannulation was possible in 18 patients (75%), one patient had no indication for tracheostomy and five children (20%) have a persisting tracheostomy including two who were lost to follow-up.

Conclusion

It is vital to outline a rational approach to the management of laryngotracheal stenosis in children based on the site and severity of the stenotic segment. No single approach is ideal and often several procedures may be required before decannulation can be achieved. Limitations of study: Patients were followed-up for 1 year. A long-term follow-up is preferable.

How to cite this article

Shekhar A, Natarajan K, Sampath R, Kameswaran M, Murali S. Outcomes in Management of Pediatric Laryngotracheal Stenosis: Our Experience. Int J Phonosurg Laryngol 2012;2(1):14-19.


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  1. Laryngotracheal reconstruction in children, 5-year follow-up. Ann Otol Rhinol Laryngol 1981;90: 516-20.
  2. Syndromic and other congenital anomalies of the head and neck. Otolaryngol Clin North Am 2003;33(6):1293-308.
  3. Successful ex utero intrapartum treatment (EXIT) procedure for congenital high airway obstruction syndrome (CHAOS) owing to laryngeal atresia. J Pediatr Surg 1998;33(10):1563-65.
  4. Single stage and multistage pediatric laryngotracheal reconstruction. Otolatyngol Clin North Am 2008;41:947-58.
  5. Congenital glottic webs in children—a retrospective review of 41 patients. Ann Otol Rhinol Laryngol 1985;121(Suppl):2-16.
  6. Laryngotracheal reconstruction in congenital laryngeal webs and atresia. Otolaryngol Head Neck Surg 2005;132(2):232-38.
  7. Resection of tracheal stenosis with end to end anastomosis. Ann Otol Rhinol Laryngol 1993;102:670.
  8. Management of the extubation problem in the premature child: Anterior cricoid split as an alternative to tracheostomy. Ann Otol Rhinol Laryngol 1980;89(6):508-11.
  9. Revision pediatric laryngotracheal reconstruction. Otolaryngol Clin N Am 2008;41:959-80.
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