Cricotracheal resection for pediatric subglottic stenosis.

Details

Serval ID
serval:BIB_203D1FDE1044
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cricotracheal resection for pediatric subglottic stenosis.
Journal
International Journal of Pediatric Otorhinolaryngology
Author(s)
Monnier P., Lang F., Savary M.
ISSN
0165-5876 (Print)
ISSN-L
0165-5876
Publication state
Published
Issued date
1999
Volume
49
Number
Suppl. 1
Pages
S283-S286
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
Until recently, cricotracheal resection (CTR) has not been commonly accepted as a treatment modality for severe subglottic stenosis in the pediatric age group. The reasons have included the risk of a possible dehiscence at the site of the anastomosis, the likelihood of injury to the recurrent laryngeal nerves, and the interference with normal growth of the larynx. Thirty-eight infants and children with a severe subglottic stenosis underwent a partial cricoid resection with primary thyrotracheal anastomosis. Thirty-three patients were tracheotomy-dependent at the time of surgery and 34 were referred cases; 27 were classified as grade III, and 10 as grade IV stenoses according to new Cotton's classification. Nineteen patients were younger than 3 years of age at the time of surgery. The tracheotomy was resected during the surgical procedure in 21 cases. Decannulation was achieved in 36/38 cases after an open procedure. There is one complete restenosis and one good result awaiting decannulation after further surgery for a Pierre Robin syndrome. The authors experienced no lesion of the recurrent laryngeal nerves and no fatality. Thirty-one patients show no exertional dyspnea, three a slight stridor while exercising, and two patients are not decannulated. The postoperative follow-up in longer than 10 years in eight cases. All patients show a normal growth of the larynx and trachea. Compared to laryngotracheoplasties, CTR gives better results for severe subglottic stenosis. This operation should become the treatment of choice for severe (grade III and IV) subglottic stenosis in infants and children.
Keywords
Child, Cricoid Cartilage/surgery, Follow-Up Studies, Humans, Infant, Laryngostenosis/surgery, Postoperative Complications, Thyroid Cartilage/surgery, Trachea/surgery
Pubmed
Web of science
Create date
01/05/2013 16:50
Last modification date
20/08/2019 13:56
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