Surgical management of congenital tracheal stenosis

Congenital tracheal stenosis is a rare and potentially lethal malformation. Although congenital tracheal stenosis carries a high mortality rate, advances in surgical treatment have increased the likelihood of survival, and these patients are seen with increasing frequency in intensive care units. The surgical options available are dilation, resection, and tracheoplasty. Because of the lack of a prosthetic replacement, resection is generally limited to lesions involving less then one third of the trachea. Tracheoplasty with a variety of graft materials has, in some cases, been successful in increasing the diameter of the stenotic trachea. Postoperative care involves maintaining paralysis and sedation until healing is established, with close attention to preventing complications. The needs of the family are addressed through teaching and support. A case of successful tracheal reconstruction, by use of an autologous cartilage graft, in a 14-day-old infant with severe stenosis from just below the vocal cords extending to the hilum is presented.