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[Multidisciplinary approach on subglottic pathology: a 5-year review]
I Miró1, C Gutiérrez1, R Fonseca1
1Servicio de Cirugía Pediátrica. Hospital Universitari i Politècnic La Fe. València.
Insights
Pediatric subglottic pathology management is challenging. Multidisciplinary approaches and tailored treatments, including microsurgery and laryngotracheoplasty, improve clinical outcomes for conditions like stenosis, cysts, and granulomas.
Area of Science:
- Pediatric Otolaryngology
- Airway Surgery
- Pediatric Respiratory Medicine
Background:
- Pediatric subglottic pathology presents significant treatment challenges.
- Effective management strategies are crucial for improving patient outcomes.
Purpose of the Study:
- To review the management of pediatric subglottic pathology.
- To evaluate treatment outcomes for stenosis, cysts, and granulomas.
Main Methods:
- Retrospective study of 27 pediatric patients with glottosubglottic pathology (2011-2016).
- Analysis of treatment modalities based on pathology type, location, and severity.
Main Results:
- Congenital stenosis treated with laryngotracheoplasty.
- Acquired stenosis managed with various techniques including microsurgery, cricotracheal resection, and tracheal dilatation.
- Subglottic cysts and granulomas primarily treated with microsurgery, with some granulomas resolving spontaneously.
Conclusions:
- Pediatric subglottic pathology management remains complex.
- A multidisciplinary Airway Committee approach has improved clinical results.
- Tailored treatment strategies are essential for optimal outcomes.
Introduction:
Pediatric subglottic pathology still represents a challenge when it comes to choosing the right treatment. We present the management of patients followed in our center for this reason during the last 5 years.
Material And Methods:
Retrospective study of patients followed by glotosubglottic pathology (stenosis, cysts or granulomas) between 2011 and 2016 in a third level hospital.
Results:
Twenty-seven patients were included in the review. Treatment options varied according to the nature, location and severity of the subglottic stenosis. Two patients with congenital subglottic stenosis were treated by laryngotracheoplasty. Seventeen patients with acquired subglottic stenosis were included: in one (5.9%) laryngotracheoplasty was performed, one (5.9%) received cricotracheal split, two of them (11.8%) underwent partial cricotracheal resection (PCTR) , seven patients (41.2%) underwent microsurgery, three (17.6%) received tracheal dilatation, and the last three (17.6%) were submitted to observation without needing further treatment. Five patients with post-intubation subglottic cysts received microsurgery. Of three patients diagnosed with post-intubation subglottic granuloma, two (66%) resolved spontaneously and one (33%) required microsurgery.
Conclusions:
Management of pediatric subglottic pathology remains a major challenge. Since the creation of the Airway Committee in our center, the improvement in the management of these patients has led to a multidisciplinary management, with the consequent impact on the clinical results.
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