Outcomes in Management of Pediatric Laryngotracheal Stenosis: Our Experience

Abstract

ABSTRACT Background Pediatric laryngotracheal stenosis is a difficult entity encountered in clinical practice which manifests with a myriad of etiologies and presentations. Management of pediatric laryngotracheal stenosis is a surgical challenge which requires meticulous preoperative evaluation and planning. Aim of study This is a retrospective study of the efficacy of different surgical techniques involved in restoring the airway patency in pediatric laryngotracheal stenosis performed at our institution over 4 years. Materials and methods Twenty-four pediatric patients underwent treatment for laryngotracheal stenosis over a 4-year period (June 2006-May 2010). Various surgical modalities, such as anterior cricoid split, costal cartilage interposition, stenting, laser procedures, etc. were used. Hood's stent, Montgomery T-tube, silastic swiss roll, indwelling nitinol tracheal stent were used to stent the airway after resection of the stenotic segment. Results Nine patients achieved successful decannulation with single-stage procedure and 14 patients underwent multiple procedures. Of 24 patients, decannulation was possible in 18 patients (75%), one patient had no indication for tracheostomy and five children (20%) have a persisting tracheostomy including two who were lost to follow-up. Conclusion It is vital to outline a rational approach to the management of laryngotracheal stenosis in children based on the site and severity of the stenotic segment. No single approach is ideal and often several procedures may be required before decannulation can be achieved. Limitations of study: Patients were followed-up for 1 year. A long-term follow-up is preferable. How to cite this article Shekhar A, Natarajan K, Sampath R, Kameswaran M, Murali S. Outcomes in Management of Pediatric Laryngotracheal Stenosis: Our Experience. Int J Phonosurg Laryngol 2012;2(1):14-19.