Related Experiment Video
Updated: May 1, 2026
Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing
Published on: December 1, 2023
[Pathologies of the larynx and trachea in childhood]
1Klinik für Hals-, Nasen-, Ohrenkrankheiten, Plastische Operationen, Klinikum Stuttgart.
Insights
Pediatric airway pathologies, including stenosis, infections, neoplasia, and foreign body aspiration, require specific diagnostic and therapeutic strategies. This review details management options, emphasizing endoscopic approaches for stenosis and careful consideration for tracheostomy in infants.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Airway Surgery
- Pediatric Respiratory Medicine
Background:
- Laryngeal and tracheal pathologies are common in children, categorized into stenosis, infections, neoplasia, and foreign body aspiration.
- Supraglottic stenosis (laryngomalacia) and subglottic stenosis are significant concerns, with cicatricial stenosis being predominant in the latter.
- Management of pediatric airway issues requires specialized diagnostic and therapeutic approaches.
Purpose of the Study:
- To review diagnostic strategies and therapeutic options for pediatric laryngeal and tracheal pathologies.
- To highlight current management techniques for various airway conditions, including stenosis, infections, neoplasia, and foreign body aspiration.
- To emphasize preferred treatment modalities and their indications in pediatric airway management.
Main Methods:
- Review of diagnostic strategies and therapeutic options for pediatric airway pathologies.
- Discussion of surgical techniques, including supraglottoplasty, cricotracheal resection, and laryngotracheal reconstruction.
- Analysis of management algorithms for foreign body aspiration and infectious diseases.
Main Results:
- Laryngomalacia is the most frequent supraglottic stenosis, treated endoscopically via supraglottoplasty.
- Subglottic stenosis, predominantly cicatricial, is best managed with cricotracheal resection or laryngotracheal reconstruction.
- Endoscopic treatment is viable for selected subglottic stenosis cases, while open reconstruction is superior for severe cases; tracheostomy indications in infants must be strict.
Conclusions:
- Effective management of pediatric airway pathologies relies on accurate diagnosis and tailored therapeutic strategies.
- Endoscopic approaches are preferred for laryngeal stenosis, while open reconstructions offer superior outcomes for severe subglottic stenosis.
- Foreign body aspiration requires a clear algorithm, and recurrent respiratory papillomatosis management should prioritize function preservation.
Abstract:
Pathologies in the larynx and trachea in the pediatric age can be characterized in 4 main groups: airway stenosis, acute infections, benign neoplasia and foreign body aspiration. In this review main diagnostic strategies and therapeutic options are presented. Laryngomalazia is the most frequent condition of supraglottic stenosis. The term supraglottoplasty summarizes all different techniques used for it's repair using an endoscopic approach. Glottic stenosis is rare in children. Usually a compromise between voice preservation and airway restoration has to be sought. Type of reconstruction and timing are varying considerably in individual cases, endoscopic approaches should be preferred. Subglottic stenosis remains the largest group in paediatric airway pathology, with cicatrial stenosis being predominant. Today, cricotracheal resection is the most successful treatment option, followed by the classical laryngotracheal reconstruction with autologous cartilage. In early infancy subglottic stenosis is particularly demanding. Endoscopic treatment is possible in selected patients, but open reconstruction is superior in more severe cases. Tracheostomy is not a safe airway in early infancy, it's indication should be strict. Foreign body aspiration needs to be managed according to a clear algorhythm. Recurrent respiratory papillomatosis should be treated with emphasis on function preservation. The role of adjuvant medication remains unclear. Infectious diseases can be managed conservatively by a pediatrician in the majority of cases.
Related Concept Videos
01:22Trachea
Anatomical Features:
Location: About half of the trachea is situated in the neck, anterior to the esophagus, and extends from the larynx (at the level of...
01:21Larynx
Anatomy of the Larynx
The larynx consists of various components, including cartilage, muscles, and vocal cords. Its structure includes three large unpaired cartilages—the thyroid, cricoid, and epiglottis—and three smaller paired cartilages—the arytenoids,...
01:31Anatomy of Respiratory System II: Lower Respiratory Tract
The Larynx
It is located between the pharynx and the trachea, acts as a passageway for air, and hosts several critical structures, such as the epiglottis, vocal cords, and glottis. The epiglottis acts as a gateway, guiding food to the...
01:23The Bronchial Tree
The trachea, commonly known as the windpipe, is a tube that connects the larynx (voice box) to the bronchi. At a point called the carina, it bifurcates into two primary bronchi. The right primary bronchus is wider, shorter, and more vertical than the left primary...
01:29Anatomy of Respiratory System I: Upper Respiratory Tract
Nose and nasal cavity
The nose and nasal cavity represent the main external openings of the respiratory tract....
01:17Pulmonary Cycle: Exhalation