An experimental model for the endoscopic correction of subglottic stenosis with clinical applications

The use of long-term endotracheal intubation in the treatment of respiratory distress syndrome in the newborn has seen an increase in the number of cases of acquired subglottic stenosis. Multiple methods of correction have been advocated in conjunction with the use of antibiotics, corticosteroids, and indwelling stents. An animal experiment utilizing 64 dogs was undertaken in an effort to devise an endoscopic procedure using the CO2 laser which might be successfully employed in the human patient. An attempt was also made to study the efficacy of antibiotics, corticosteroids, soft stents and rigid stents. Animals were divided into multiple groups, and their larynges were studied grossly and histologically some weeks after therapy was completed. Analysis of the results was undertaken, and the method with the best outcome was then employed in the human portion of the study. Twenty-four human patients, 12 with severe stenosis and 12 with partial stenosis were evaluated, and their outcome is reported.