Abstract
Introduction This retrospective study describes our experience in the evaluation and management of infants with subglottic stenosis. Materials and Methods The study included 10 patients aged between 1 wk and 18 months with 6 cases having congenital subglottic stenosis and 4 cases having acquired subglottic stenosis. Results 6 patients had grade I, 3 patients had grade II, and 1 patient had grade III subglottic stenosis. Tracheostomy was required in 4 patients at the time of presentation. 7 patients were treated successfully with Bougie dilation followed by topical application of mitomycin, whereas 1 patient who failed to serial dilation needed open reconstructive procedure. Laser excision of the anterior subglottic web was performed in one patient. Another patient with underlying cerebral palsy could not be operated upon and was managed with tracheostomy. Conclusion Subglottic stenosis may be effectively man-aged with endoscopic surgical techniques, although the number of such sittings required varies with the type and severity of stenosis. Open surgical procedures need to be individualised as per the needs of the patient only after all the other endoscopic possibilities have been exhausted.
Highlights
Subglottic stenosis (SGS) is a narrowing of the subglottic airway, which is housed in the cricoid cartilage, i.e., below the glottis and above the first tracheal ring [1]. is can be congenital or acquired
One of the patients with acquired subglottic stenosis had developed neonatal septicemia and remained intubated for 6 weeks. e patient presented with repeated episodes of desaturation which were aggravated by upper respiratory tract infection (URTI). e patient had developed fibrosis and granulations predominantly posteriorly and was tracheostomised
Another patient with acquired subglottic stenosis presented at the age of 18 months when he had undergone repeated intubations for multiple surgeries for congenital vesicourinary anomalies (Figures 1–3) and needed tracheostomy at the time of presentation
Summary
Otorhinolaryngology, Head & Neck Surgery, Government Medical College Srinagar, Srinagar, Jammu & Kashmir, India. Is retrospective study describes our experience in the evaluation and management of infants with subglottic stenosis. E study included 10 patients aged between 1 wk and 18 months with 6 cases having congenital subglottic stenosis and 4 cases having acquired subglottic stenosis. Tracheostomy was required in 4 patients at the time of presentation. Laser excision of the anterior subglottic web was performed in one patient. Another patient with underlying cerebral palsy could not be operated upon and was managed with tracheostomy. Subglottic stenosis may be effectively man-aged with endoscopic surgical techniques, the number of such sittings required varies with the type and severity of stenosis. Open surgical procedures need to be individualised as per the needs of the patient only after all the other endoscopic possibilities have been exhausted
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