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Contemporary surgical strategies for pediatric laryngotracheal stenosis: a comprehensive review

Hanne Oscé1, Jeroen Meulemans1, Greet Hens1

  • 1Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.

Frontiers in Pediatrics
|September 11, 2025
PubMed

Insights

Surgical strategies for pediatric laryngotracheal stenosis (LTS) vary by severity and site. Techniques like laryngotracheal reconstruction (LTR) and partial cricotracheal resection (PCTR) offer high decannulation rates, with tailored approaches improving outcomes.

Area of Science:

  • Pediatric Otolaryngology
  • Airway Surgery
  • Pediatric Critical Care

Background:

  • Pediatric laryngotracheal stenosis (LTS) is a complex airway obstruction requiring individualized surgical management.
  • Treatment decisions depend on stenosis severity, location, and patient comorbidities.
  • Surgical options include laryngotracheal reconstruction (LTR), partial cricotracheal resection (PCTR), and endoscopic techniques.

Purpose of the Study:

  • To review and synthesize current surgical strategies for pediatric LTS.
  • To highlight indications, operative considerations, and outcomes for various surgical techniques.
  • To discuss factors influencing surgical success in pediatric LTS.

Main Methods:

  • This study is a narrative review of current literature on pediatric LTS surgical management.
  • It synthesizes information on surgical techniques, patient selection, and perioperative care.
  • Outcomes and success factors are analyzed based on published data.

Main Results:

  • Single-stage LTR is suitable for moderate subglottic stenosis (SGS) in healthy children.
  • PCTR demonstrates superior results for severe or recurrent LTS.
  • Endoscopic posterior cricoid split with rib grafting (EPCS/RG) offers a minimally invasive option for specific posterior glottic stenosis cases.
  • Decannulation rates exceed 85% in well-selected pediatric LTS patients.
  • Functional outcomes (voice, swallowing) vary depending on the surgical technique used.

Conclusions:

  • Optimal pediatric LTS management necessitates a multidisciplinary and individualized approach.
  • Continued research into long-term functional outcomes and technical advancements is crucial.
  • Multicenter collaborations can further enhance patient care and treatment standardization.
Abstract

Keywords:
airway surgerycricotracheal resectionlaryngotracheal reconstructionlaryngotracheal stenosispediatric airwaysubglottic stenosis

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