ORIGINAL ARTICLES   

Chirurgia 2015 October;28(5):173-6

Copyright © 2015 EDIZIONI MINERVA MEDICA

language: English

Surgical treatment of pediatric subglottic stenosis

Yalcin Comert H. S. ¹, Sarihan H. ¹, Imamoglu M. ¹, Tusat M. ², Besir A. ³

¹ Karadeniz Technical University, Faculty of Medicine, Department of Pediatric Surgery, Trabzon, Turkey; ² Kilis Government Hospital, Department of Pediatric Surgery, Kilis, Turkey; ³ Karadeniz Technical University, Faculty of Medicine, Department of Anesthesiology, Trabzon, Turkey

AIM: Subglottic stenosis (SGS) is a rare anomaly caused by thickened cricoid cartilage. Acquired subglottic stenosis can be occured secondary to prolonged endotracheal intubation or trauma. The aim of this study was to clarify outcomes of our surgical management and to outline our surgical strategy for SGS, which includes dilatation, posterior sagital incision with T-Tube stenting and laryngo tracheoplasty tecniques (LTP).
METHODS: Since 1997, a total of thirteen patients with SGS have been treated at our institution. The diagnosis was confirmed by rigid bronchoscopy under general anesthesia. Severity of subglottic airway stenosis was graded according to the Myer–Cotton classification system. The seven patients of Grade I-II stenosis has need only broncoscopy and dilatation. Tracheostomy was applied to the all patients who have had Grade III stenosis. Thereafter 2 months posterior sagital incision with modified T-Tube stenting or LTP procedures were applied. All thirteen patients were succesfully discharged from the hospital.
RESULTS: Laryngotracheal stenosis (LTS) is defined as congenital or acquired narrowing of the airway that may affect the glottis, subglottis, and trachea. SGS is absolutely suggested to the newborns who have low apgar scores, history of prolonged endotracheal intubation and difficult intubation or intubated with small french number of tubes. We clarify outcomes of our surgical managements. Our all patients succesfully discharged and no new disease has occured in our follow-up.
CONCLUSIONS: We must be alert for prolonged endotracheal intubation patients to take acuse for SGS and we require more study and experience for a standart treatment concensus of SGS.