Pathologies of the larynx and trachea in childhood

Area of Science:

• Pediatric Otolaryngology
• Pediatric Airway Surgery
• Pediatric Respiratory Medicine

Background:

• Laryngeal and tracheal pathologies in children are categorized into airway stenosis, infections, neoplasia, and foreign body aspiration.
• Laryngomalacia is the most common supraglottic stenosis, often managed with supraglottoplasty.
• Subglottic stenosis, particularly cicatricial, is the predominant pediatric airway pathology.

Purpose of the Study:

• To present diagnostic strategies and therapeutic options for pediatric laryngeal and tracheal pathologies.
• To review current management approaches for airway stenosis, infections, neoplasia, and foreign body aspiration in children.
• To emphasize preferred surgical techniques and indications for various pediatric airway conditions.

Main Methods:

• Review of diagnostic strategies for pediatric airway pathologies.
• Presentation of therapeutic options including endoscopic and open surgical techniques.
• Discussion of management algorithms for foreign body aspiration and infectious diseases.

Main Results:

• Supraglottoplasty is used for supraglottic stenosis; glottic stenosis requires balancing voice and airway, favoring endoscopic repair.
• Cricotracheal resection and laryngotracheal reconstruction with cartilage are key for subglottic stenosis.
• Endoscopic treatment is viable for select subglottic stenosis cases, while open reconstruction is superior for severe cases.

Conclusions:

• Management of pediatric airway pathologies necessitates tailored diagnostic and therapeutic approaches.
• Endoscopic techniques are preferred for supraglottic and select glottic stenosis.
• Advanced surgical interventions like cricotracheal resection are crucial for severe subglottic stenosis, with tracheostomy use strictly indicated in early infancy.