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[Tracheal stenosis: individualized treatment]
J L Antón-Pacheco Sánchez1, J Cuadros García, M A Villafruela Sanz
1Servicio de Cirugía Pediátrica y Unidad de la Vía Aérea, Hospital Universitario 12 de Octubre, Madrid.
Insights
Pediatric airway stenosis, including congenital and acquired tracheal stenosis (CTS and ATS) and suprastomal tracheal collapse (STC), requires tailored treatment. Multidisciplinary teams achieve good outcomes in most cases.
Area of Science:
- Pediatric Surgery
- Respiratory Medicine
- Otolaryngology
Context:
- Stenosing airway disease is rare in children.
- It encompasses intraluminal obstructions, extrinsic compressions, and malacias.
- Congenital and acquired tracheal stenosis (CTS and ATS) and suprastomal tracheal collapse (STC) present unique challenges.
Purpose:
- To present the experience in managing pediatric tracheal stenosis and suprastomal collapse.
- To evaluate treatment outcomes for various airway stenotic lesions.
- To highlight the importance of individualized treatment strategies.
Summary:
- A study evaluated 24 pediatric patients with CTS, ATS, or STC.
- Treatments included tracheoplasty, resection and anastomosis, cricoid suspension, dilation, and laser resection.
- Good results were achieved in 77% of treated patients.
Impact:
- Demonstrates the effectiveness of diverse surgical interventions for pediatric airway stenosis.
- Emphasizes the need for personalized treatment plans.
- Highlights the role of multidisciplinary teams in optimizing patient outcomes.
Introduction:
Stenosing airway disease is unfrequent in the pediatric age group and includes intraluminal obstructions, extrinsic compressions and malacias.
Objective:
To show our experience in the treatment of congenital and acquired tracheal stenosis (CTS and ATS) and suprastomal tracheal collapse (STC).
Patients And Methods:
Since 1990, 24 patients have been evaluated in our Unit: Ten CTS, 5 ATS and 9 STC. We have studied the following parameters: Sex, age at diagnosis, ethiology, type of lesion, associated anomalies, treatment, postoperative intubation, length of hospital stay, number of bronchoscopies, complications and follow-up.
Results:
14 girls and 10 boys are included in this survey. Age at diagnosis ranged from 3 days to 12 years and associated anomalies were present in 75% of cases. We have treated 22 of the 24 patients with the following procedures: Costal cartilage tracheoplasty (6 cases), slide tracheoplasty (2), resection and anastomosis (3), anterior cricoid suspension (8), dilation (2) and laser resection (1). We have achieved good results in 17 patients (77%), bad in 4 (18%) and fair in one.
Conclusions:
Due to the variety of stenotic lesions, we think that treatment should be tailored to each particular case and performed by a multidisciplinary pediatric team in order to achieve the best results.