[Paediatric laryngotracheal stenosis]

Area of Science:

• Pediatric Otolaryngology
• Airway Surgery
• Pediatric Respiratory Medicine

Background:

• Laryngotracheal stenosis in infants and children presents complex diagnostic and therapeutic challenges.
• Effective management necessitates specialized expertise and individualized treatment plans.
• This paper reviews key pediatric airway pathologies and their management.

Purpose of the Study:

• To present the most important presentations of airway pathology in children.
• To discuss conservative, endoscopic, and surgical treatment options for pediatric laryngotracheal stenosis.
• To highlight the need for specialized centers for managing these rare conditions.

Main Methods:

• Review of conservative, endoscopic, and surgical treatment modalities for pediatric airway stenosis.
• Discussion of specific techniques including supraglottoplasty for laryngomalacia.
• Evaluation of cricotracheal resection and laryngotracheal reconstruction for subglottic stenosis.

Main Results:

• Laryngomalacia is the most common supraglottic stenosis, treated endoscopically via supraglottoplasty.
• Glottic stenosis is rare, often requiring a balance between voice and airway, with preference for endoscopic approaches.
• Subglottic stenosis, predominantly cicatricial, is best managed with cricotracheal resection or laryngotracheal reconstruction; endoscopic options are limited to selected cases.

Conclusions:

• Pediatric subglottic stenosis is the largest group of airway pathology, demanding significant expertise.
• While endoscopic treatments are viable for select cases, open reconstructions like cricotracheal resection are superior for severe subglottic stenosis.
• Due to limited incidence and complexity, pediatric airway stenosis cases should be managed at referral centers.