Subglottic Stenosis: Current Concepts and Recent Advances

DeRowe, Ari; Wasserzug, Oshri

doi:10.5005/jp-journals-10001-1272

Cited by 6 publications

(4 citation statements)

References 42 publications

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“…One of the acquired causes is intubation. Approximately 1-2% of intubated neonates, (which can reach up to 11% for children under 5 years of age) might develop subglottic stenosis after endotracheal intubation (1). Patient with mild subglottic stenosis are usually asymptomatic with normal respiratory ndings (2).…”

Section: Discussionmentioning

confidence: 99%

Halothane sedation with local anesthesia as a bailout procedure for neonate with subglottic stenosis and post-MMC repair defect for O-Z flap: a case report

Shimekit,

Eshetie,

Lemma

2024

Preprint

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Introduction: Subglottic stenosis (SGS) can develop after intubation in children. With mild subglottic stenosis, children can be asymptomatic. Endotracheal intubation is difficult in infants with subglottic stenosis. Here is a case of subglottic stenosis in infant planned for flap wound closure managed with sedation. Case presentation: A 1 month-old infant for whom thoracolumbar myelomeningocele (MMC) was repaired during her 2nd week of life, then she developed a wound infection on the 4th postoperative day, and after 2 weeks she was scheduled for a wound closure. However, intubation was difficult and rescheduled but with the senior anesthesiologist it was not possible to intubate and after discussion with an anesthesiologist sedation and local anesthesia was used to proceed with wound closure with a flap. Conclusion sedation with local anesthesia can be used for neonates and infants with subglottic stenosis when intubation is difficult.

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Section: Discussionmentioning

confidence: 99%

Halothane sedation with local anesthesia as a bailout procedure for neonate with subglottic stenosis and post-MMC repair defect for O-Z flap: a case report

Shimekit,

Eshetie,

Lemma

2024

Preprint

View full text Add to dashboard Cite

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“…Therefore, general TIVA with spontaneous ventilation is preferred. 2 The child should be deep enough to allow the procedure to be performed but not too deep so as to abolish spontaneous respiration. This balance is an art that requires continuous communication between the surgeon and anaesthesiologist.…”

Section: Casementioning

confidence: 99%

“…Airway dilatation (balloon/bougie) has become very effective for correction of stenosis. 1,2 Anaesthesia for airway dilatation in subglottic stenosis is extremely challenging and here we report our experience with anaesthetic management of two such patients along with relevant review of literature that provides ideal anaesthesia management options for such patients.…”

Section: Introductionmentioning

confidence: 99%

Anaesthesia for bougie dilatation of subglottic stenosis: report of two cases

Raju,

Chambath,

Kannamadathy Poulose

2023

Int J Res Med Sci

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Subglottic stenosis is a rare but life-threatening condition characterized by narrowing of subglottis. Airway dilatation (balloon/bougie) has become very effective for correction of stenosis. Anaesthesia management for bougie or balloon dilatation of subglottic stenosis needs proper planning, team work and efficient utilization of resources. Airway management options include apneic pause technique, supraglottic jet ventilation, THRIVE (transnasal humidified rapid insufflation ventilatory exchange) and cardiopulmonary bypass/extracorporeal membrane oxygenation in emergency scenario. Total intravenous anaesthesia along with airway anaesthesia remains the best anesthetic management option as it provides excellent conditions for shared airway surgery.

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“…20 The authors outlined a 4-point grading system: grade I involving ≤ 50% obstruction, grade II between 51% and 70%, grade III between 71% and 99% obstruction, grade IV indicating no detectable lumen. 20,21 Since the introduction of the Cotton-Myer system, however, it has been widely adopted in assessing adult stenoses, although it has been shown to suffer poor reliability. 22 Although this classification scheme is widely adopted, its reliability from endoscopic visualization and correlation with radiographic measurements has not been well-established in the literature and only studied in small cohorts.…”

Section: Introductionmentioning

confidence: 99%

Correlations of Radiographic and Endoscopic Observations in Subglottic Stenosis

Bourdillon

Hajek

Wride

et al. 2021

Ann Otol Rhinol Laryngol

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Objective(s): Subglottic stenosis (SGS) represents a constellation of diverse pathologic processes that ultimately lead to narrowing of the subglottic region and can produce significant morbidity. Existing endoscopic and radiographic assessments may not be consistent in practice. Methods: Severity of stenosis was evaluated and reported using the Cotton-Myer classification system from 33 endoscopic procedures from 32 unique subjects. Radiographic imaging within the preceding 3 month period was subsequently reviewed and narrowing was measured by a blinded radiologist. Degree of stenosis was reported as a percentage in 30 out of 33 endoscopic evaluations and subsequently compared to radiographically determined percentage of stenosis. Statistical analyzes were conducted to evaluate concordance between endoscopic and radiographic assessments. Results: About 45.5% (15/33) of the evaluations were in agreement using Cotton-Myer scoring, while 27.3% (9/33) were discrepant by 1 grade and 27.3% (9/33) by 2 grades. Correlation of degree of stenosis as a percentage using Spearman (coefficient: 0.233, P-value: .214) and Pearson (coefficient: 0.138, P-value: .466) methods demonstrated very weak relationships. Radiographic scoring did not predict endoscopic classification to a significant degree using mixed effects regression. Conclusions: Radiographic and endoscopic grading of subglottic stenosis may not be reliably concordant in practice.

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Subglottic Stenosis: Current Concepts and Recent Advances

Cited by 6 publications

References 42 publications

Halothane sedation with local anesthesia as a bailout procedure for neonate with subglottic stenosis and post-MMC repair defect for O-Z flap: a case report

Halothane sedation with local anesthesia as a bailout procedure for neonate with subglottic stenosis and post-MMC repair defect for O-Z flap: a case report

Anaesthesia for bougie dilatation of subglottic stenosis: report of two cases

Correlations of Radiographic and Endoscopic Observations in Subglottic Stenosis

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