Management of severe pediatric subglottic stenosis with glottic involvement

George, Mercy; Jaquet, Yves; Ikonomidis, Christos; Monnier, Philippe

doi:10.1016/j.jtcvs.2009.05.010

Cited by 44 publications

(24 citation statements)

References 28 publications

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“…Although there are no published data comparing LTR and PCTR for SGS, it is generally accepted that PCTR yields a higher decannulation rate and should be attempted as a primary surgery in children with grades III and IV SGS 4, 5. Extended PCTR provides a fully mucosalized reconstruction on completion of the surgery, with adequate stabilization of the laryngotracheal framework.…”

Section: Commentarymentioning

confidence: 99%

Management of severe glotto‐subglottic stenosis in children

2012

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Section: Commentarymentioning

confidence: 99%

Management of severe glotto‐subglottic stenosis in children

2012

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“…Edema immediately after extubation is frequently improved by epinephrine inhalation and steroid administration. However, that caused by granulation hardens not only the subglottis but also the vocal cords, and vocal cord paralysis frequently requires surgical treatment [4]. In the present case, the respiratory difficulty that occurred after removal of the first tracheal tube might have been caused by airway edema.…”

Section: Discussionmentioning

confidence: 65%

Anesthetic management during tracheotomy in a child with respiratory distress caused by severe intubation-induced glottic stenosis

et al. 2012

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We provided anesthetic management during a tracheotomy procedure for a child who demonstrated labored respiration during inspiration because of severe glottic stenosis and bilateral vocal cord paralysis caused by tracheal intubation. A 4-year-old boy developed acute respiratory depression associated with influenza pneumonia and had been under respiratory management with mechanical ventilation with tracheal intubation for 3 days. Following extubation, an upper-airway obstruction immediately appeared. The symptoms later worsened because of development of a common cold, and the patient underwent an emergency tracheotomy. For anesthetic management, we used a combination of ketamine with low-concentration sevoflurane inhalation. The tracheotomy was performed safely without respiratory complications by employing manual-assisted ventilation, while spontaneous breathing was preserved by use of a face mask.

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“…Más del 90% de las estenosis son adquiridas; la intubación endotraqueal es la causa principal. [1][2][3][4][5][6] La incidencia de estenosis posintubación es de 0,9% a 3%. 2 Es más frecuente en la infancia porque la subglotis es la zona más estrecha de la vía aérea pediátrica y está rodeada en su totalidad por cartílago (el anillo cricoides).…”

Section: Tratamiento De Las Estenosis Laríngeas Adquiridas En Pediatrunclassified

Tratamiento de las estenosis laríngeas adquiridas en pediatría. Serie de casos

Cuestas¹,

Urquizo²,

Demarchi³

et al. 2013

Arch Argent Pediat

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Arch Argent Pediatr 2013;111(6):e136-e140 / e136Presentación de casos clínicos RESUMEN La estenosis subglótica es una de las causas más frecuentes de obstrucción de la vía aérea superior en los niños. Si bien puede tener un origen congénito, la mayoría de las estenosis son adquiridas. Debe pensarse en esta patología en todo niño con antecedentes de intubación, instrumentación o trauma de la vía aérea que presenta dificultad respiratoria. El diagnóstico se sospecha por la clínica, los antecedentes y la radiografía cervical, y se confirma mediante el examen endoscópico. La conducta terapéutica dependerá, entre otros factores, del grado de estenosis que se presente. Describimos nuestra experiencia con 6 pacientes que presentaban estenosis subglótica posintubación, tratados quirúrgicamente con técnica de expansión. Palabras clave: estenosis subglótica, niños, intubación endotraqueal, tratamiento quirúrgico. AbStRActSubglottic stenosis is one of the most common causes of upper airway obstruction in children. Even though it may have a congenital origin, most of them are acquired stenosis. This condition should be suspected in any child with a history of intubation, instrumentation or trauma of the airway that is having difficulty breathing. The diagnosis is suspected by clinical, history and cervical radiograph, and is confirmed by endoscopic examination. Among others factors the treatment depends on the stenosis degree. We describe our experience with 6 patients with post-intubation subglottic stenosis treated surgically with expansion technique.

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Management of severe pediatric subglottic stenosis with glottic involvement

Abstract: Glotto-subglottic stenosis is a complex laryngeal injury associated with delayed decannulation and decreased overall and operation-specific decannulation rates when compared with those after subglottic stenosis without glottic involvement after partial cricotracheal resection.

Cited by 44 publications

References 28 publications

Management of severe glotto‐subglottic stenosis in children

Management of severe glotto‐subglottic stenosis in children

Anesthetic management during tracheotomy in a child with respiratory distress caused by severe intubation-induced glottic stenosis

Tratamiento de las estenosis laríngeas adquiridas en pediatría. Serie de casos

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