Partial cricotracheal resection for severe pediatric subglottic stenosis: update of the Lausanne experience.

Details

Serval ID
serval:BIB_77291828935B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Partial cricotracheal resection for severe pediatric subglottic stenosis: update of the Lausanne experience.
Journal
Annals of Otology, Rhinology, and Laryngology
Author(s)
Monnier P., Lang F., Savary M.
ISSN
0003-4894 (Print)
ISSN-L
0003-4894
Publication state
Published
Issued date
1998
Volume
107
Number
11 Pt 1
Pages
961-968
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
Until recently, severe pediatric subglottic stenosis (SGS) has been treated almost exclusively by laryngotracheoplasty procedures. Even in the most experienced centers, the results of single-stage operations for Cotton's grade III and IV stenoses have been disappointing. This paper reports our experience on 31 partial cricotracheal resections for severe SGS in infants and children. The stenosis was congenital in 6 cases and acquired after prolonged intubation in 25 cases. Twenty-seven patients were tracheotomy-dependent at the time of surgery. Twenty-two cases were classified as grade III and 9 cases as grade IV stenoses according to Cotton. The decannulation rate was 97% (30 of 31 cases) after an open procedure. There were no fatalities and no lesions to the recurrent laryngeal nerves, but there was 1 complete restenosis. Twenty-seven patients show no exertional dyspnea, 3 have a slight stridor with some dyspnea while exercising, and 1 patient is not decannulated. The voice is normal in 21 cases, a dysphonia is present in 9 cases, and the patient with complete restenosis acquired an esophageal voice. Postoperative follow-up is longer than 10 years in 8 cases and longer than 5 years in an additional 6 cases. All patients who reached adulthood show normal growth of the larynx and trachea. Considering the excellent results obtained in this consecutive series of 31 cases, partial cricoid resection with primary thyrotracheal anastomosis should be considered an important treatment option for severe SGS in infants and children.
Keywords
Anastomosis, Surgical, Child, Child, Preschool, Cricoid Cartilage/surgery, Female, Glottis, Humans, Infant, Intubation, Intratracheal/adverse effects, Laryngostenosis/congenital, Laryngostenosis/etiology, Larynx/surgery, Male, Medical Illustration, Postoperative Complications, Postoperative Period, Trachea/surgery, Tracheotomy, Treatment Outcome
Pubmed
Web of science
Create date
01/05/2013 15:45
Last modification date
20/08/2019 14:34
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