Strategy for surgical treatment of congenital subglottic stenosis in childrenReport as inadecuate




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Pediatric Surgery International

, Volume 28, Issue 11, pp 1115–1118

First Online: 29 August 2012Accepted: 11 July 2012

Abstract

Background-purposeCongenital subglottic stenosis is a rare anomaly caused by thickened cricoid cartilage. We report our surgical techniques, comprising anterior cricoid split ACS, laryngotracheoplasty LTP, KTP laser ablation, and application of a tracheal opening retainer TOR into the tracheostomy site.

MethodsNine patients have been treated since 1988. Four patients median age 85 days; range 5 days to 6 months underwent ACS. Another four patients median age, 17 months; range, 5–57 months underwent LTP using costal cartilage grafts, although two had undergone tracheostomy before LTP. One patient underwent LTP, ablation of the projecting part of the cricoid cartilage with KTP laser LTP + Laser and, preservation of the tracheal opening by placement of the TOR.

ResultsAll ACS and LTP patients were successfully extubated at a median of 32 days range 23–91 days and 23 days range 6–31 days postoperatively, respectively. The LTP + Laser patient was extubated 35 days after surgery and the TOR was removed asymptomatically 20 days after extubation of the stent tube.

ConclusionsAnterior cricoid split is useful for patients ≤6 months old and LTP is useful for patients >6 months old and-or with tracheostomy. KTP laser ablation is effective to remove thickened parts of cricoid cartilage protecting the vocal cords. The tracheal opening preserved by the TOR works as an additional channel to safeguard respiration during the extubation process.

KeywordsCongenital subglottic stenosis Laryngotracheoplasty Costal cartilage graft KTP laser Tracheal opening retainer  Download fulltext PDF



Author: Mitsumasa Okamoto - Eiji Nishijima - Akiko Yokoi - Makoto Nakao - Yuko Bitoh - Hiroshi Arai

Source: https://link.springer.com/article/10.1007/s00383-012-3134-2







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