Subglottic stenosis

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• 作者：Niall D. Jefferson ; MD ; FRACS^a ; Aliza P. Cohen ; MA^a ; Michael J. Rutter ; MBChB ; FRACS^a ; ^b ; ^{Mike.Rutter@cchmc.org" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Pediatric subglottic stenosis ; Endoscopic management ; Balloon dilatation ; Laryngotracheal reconstruction ; Congenital subglottic stenosis ; Acquired subglottic stenosis ; Pediatric ; Open airway reconstruction ; Endoscopic airway surgery
• 刊名：Seminars in Pediatric Surgery
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：25
• 期：3
• 页码：138-143
• 全文大小：2136 K

文摘

Subglottic stenosis (SGS) is a congenital or acquired condition characterized by a narrowing of the upper airway extending from just below the vocal folds to the lower border of the cricoid cartilage. With the introduction of prolonged intubation in neonates (mid 1960s), acquired SGS became the most frequent cause of laryngeal stenosis; unlike congenital SGS, it does not improve with time. Laryngeal reconstruction surgery evolved as a consequence of the need to manage these otherwise healthy but tracheotomized children. Ongoing innovations in neonatal care have gradually led to the salvage of premature and medically fragile infants in whom laryngeal pathology is often more severe, and in whom stenosis often involves not only the subglottis, but also the supraglottis or glottis—causing significant morbidity and mortality. The primary objective of intervention in these children is decannulation or preventing the need for tracheotomy. The aim of this article is to present a more detailed description of both congenital and acquired SGS, highlighting the essentials of diagnostic assessment and familiarizing the reader with contemporary management approaches.