[The prevention and management of tracheal and laryngeal steeosis in children (author's transl)].
During chronic intubation or tracheostomy in children, there is a risk of stenosis at three sites: the cricoid ring, the tracheostomy and the area of tube cuff inflation. The following measures are recommended to prevent this occurrence: endoscopic examination of the mucous membranes when changing the intubation tube or the tracheal cannula: nasotracheal intubation with the smallest possible diameter tubes when chronic intubation is required; use of the "open-type" tracheostomy utilizing mucosaskin retraction sutures but with out removal of tracheal cartilage. Careful inflation of the cuff and regular changing of the position of the cuff in ther cervican trachea also lower the risk of pressure-induced injury. Infection or co-existing metabolic disease increases mucosal sensitivity to pressure. Several stenosis of the laryngotracheal regions frequently requires staged laryngeal and tracheal plastic reconstruction. The curvature and stiffening of the ventral wall of the trachea can be achieved by the implantation of arched homograft cactilage taken from a tissue bank.
D002648:Child; D002675:Child, Preschool; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D007829:Laryngostenosis / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D014135:Tracheal Stenosis / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D014140:Tracheotomy / Q000009:adverse effects
Zur Verhütung und Behandlung von Kehlkopf- und Luftröhrenstenosen im Kindesalter