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Subglottic Stenosis

Alexander P Marston1, David R White1

  • 1Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, MUSC Children's Hospital, Medical University of South Carolina, 135 Rutledge Avenue, MSC 550, Charleston, SC 29425, USA.

Clinics in Perinatology
|November 7, 2018
PubMed

Insights

Pediatric subglottic stenosis, a narrowing of the airway, is increasingly managed with endoscopic techniques. Severe cases still often require open surgery for successful tracheostomy decannulation.

Area of Science:

  • Otolaryngology
  • Pediatric Airway Surgery
  • Pediatric Critical Care

Background:

  • The subglottis, a narrow pediatric airway segment, is highly susceptible to stenosis.
  • Improved endotracheal tube management has reduced acquired subglottic stenosis incidence.
  • Severe subglottic stenosis often necessitates tracheostomy dependence.

Purpose of the Study:

  • To review current management strategies for pediatric subglottic stenosis.
  • To highlight advances in otolaryngology interventions.
  • To discuss surgical options for severe cases.

Main Methods:

  • Review of current literature on subglottic stenosis management.
  • Analysis of endoscopic and open surgical techniques.
  • Evaluation of tracheostomy avoidance and decannulation rates.

Main Results:

  • Endoscopic interventions like balloon dilation and cricoid splitting can avoid tracheostomy in mild to moderate stenosis.
  • Open surgical techniques, including laryngotracheal reconstruction and cricotracheal resection, achieve high decannulation rates in severe cases.

Conclusions:

  • Advances in otolaryngology offer improved outcomes for pediatric subglottic stenosis.
  • Endoscopic approaches are effective for less severe stenosis.
  • Open surgery remains crucial for managing severe subglottic stenosis and achieving decannulation.

Keywords:
Acquired subglottic stenosisCongenital subglottic stenosisCricotracheal resectionLaryngotracheal reconstructionProlonged endotracheal intubationSubglottic balloon dilation

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