[The prevention and treatment of laryngeal and tracheal stenoses in children].
During long-term intubation and tracheotomy in childhood there is risk of stenosis in 3 regions: 1. in the area of the cricoid (ring) cartilage, 2. in the area of the tracheostomy, 3. in the area of the inflated cuff of the tube. To prevent this it is recommended to take an endoscopic look at the mucous membranes when changing the intubation tube or the tracheal cannula; to use for long-term intubation the naso-tracheal approach, combined with a tube with the smallest possible diameter; to use the "open-type tracheotomy" with a mucous membrane-epidermis suture and without the removal of cartilage. Careful inflation of the cuff and rhythmical changing of the position of the cuff in the cervical segment of the trachea lower the risk of pressure-induced damage. If there is an infection or a metabolic disease the mucous membranes are extremely sensitive to pressure. Serious stenoses frequently make laryngical and tracheal plastic surgery in several sessions necessary. The curvature and stiffening of the ventral wall of the trachea can be achieved by implantation of arched cartilage from the cartilage bank.
D002648:Child; D002675:Child, Preschool; D006801:Humans; D007440:Intubation / Q000009:adverse effects; D009092:Mucous Membrane / Q000473:pathology; D014135:Tracheal Stenosis / Q000517:prevention & control*; D014140:Tracheotomy / Q000009:adverse effects / Q000379:methods
Zur Verhütung und Behandlung von Kehlkopf-und Luftröhrenstenosen im Kindesalter