Subglottic stenosis in children. A management protocol plus surgical experience in 13 cases

Subglottic stenosis in young children represents a formidable management problem. The role of radiological evaluation, endoscopy, endotracheal intubation, tracheotomy, decannulation and surgery in the overall approach to this group of patients is discussed. Experience with laryngotracheal reconstruction in 13 patients is related; decannulation was achieved in 11 children. In general, 3 types of surgical procedures for laryngotracheal reconstruction have been described in the literature. Surgery is indicated in a minority of children with persistent significant subglottic stenosis. Specific contraindications to surgery are delineated. Appropriate management of endotracheal tubes and avoidance of aggressive endoscopy will minimize the development of subglottic stenosis.