Management of severe pediatric subglottic stenosis with glottic involvement.

Details

Serval ID
serval:BIB_79FF3F4402AD
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Management of severe pediatric subglottic stenosis with glottic involvement.
Journal
Journal of Thoracic and Cardiovascular Surgery
Author(s)
George Mercy, Jaquet Yves, Ikonomidis Christos, Monnier Philippe
ISSN
1097-685X[electronic]
Publication state
Published
Issued date
2010
Volume
139
Number
2
Pages
411-417
Language
english
Abstract
OBJECTIVE: We sought to describe our experience in the management of complex glotto-subglottic stenosis in the pediatric age group. METHODS: Between 1978 and 2008, 33 children with glotto-subglottic stenosis underwent partial cricotracheal resection, and they form the focus of this study. They were compared with 67 children with isolated subglottic stenosis (no glottic involvement). The outcomes measured were need for revision open surgical intervention, delayed decannulation (>6 months), and operation-specific and overall decannulation rates. Fisher's exact test was used for comparison of outcomes. RESULTS: Results of preoperative evaluation showed Myer-Cotton grade III or IV stenosis in 32 (97%) patients and grade II stenosis in 1 patient. All patients with glotto-subglottic stenosis were treated with partial cricotracheal resection and simultaneous repair of the glottic pathology. Bilateral fixed vocal cords were seen in 19 (58%) of 33 patients, bilateral restricted abduction was seen in 7 (21%) of 33 patients, and unilateral fixed vocal cord was seen in 7 (21%) of 33 patients. Ten patients underwent single-stage partial cricotracheal resection with excision of interarytenoid scar tissue. The endotracheal tube was kept for a mean period of 7 days as a stent. Twenty-three patients underwent extended partial cricotracheal resection with LT-Mold (Bredam S.A., St. Sulpice, Switzerland) or T-tube stenting. The overall decannulation rate included 26 (79%) patients, and the operation-specific decannulation rate included 20 (61%) patients. CONCLUSIONS: Glotto-subglottic stenosis is a complex laryngeal injury associated with delayed decannulation and decreased overall and operation-specific decannulation rates when compared with those after subglottic stenosis without glottic involvement after partial cricotracheal resection.
Pubmed
Web of science
Open Access
Yes
Create date
16/02/2010 10:04
Last modification date
20/08/2019 14:36
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