[Laryngotracheal stenosis in children. Current aspects of the surgical treatment and prevention].
In the past 6 years, 40 children underwent surgery for laryngotracheal stenosis; 32 by the external approach, 8 by endoscopic CO2 laser. Twenty-seven children (67%) were less than 5 years old at the moment of treatment and 80% of the stenoses (n = 32) corresponded to an etiology that is secondary to endotracheal intubation and/or tracheotomy. By grading the stenoses according to the amount of narrowing of the lumen, the authors emphasize the interest of conservative treatment (endoscopic) for grade I (less than 70%, n = 8), and treatment by external surgical methods for grade II (70%-90%, n = 13), grade III (90%-99%, n = 14), and grade IV (total obstruction, n = 5). At this time, the most commonly used technique is laryngotracheoplasty with costal cartilage interposition. In this series, 88% of the patients were successfully decannulated. As for the treatment of stenosis in infants, the authors describe their recent experience of laryngotracheofissure in 7 patients as an alternative to either tracheotomy in cases of difficult extubation or laryngotracheoplasty when the child is underweight.
Carcassonne
M
M
Département de Chirurgie Pédiatrique, C.H.U. Timone-enfants, Marseille.
Triglia
J M
JM
Guys
J M
JM
Delarue
A
A
D000293:Adolescent; D002358:Cartilage, Articular / Q000637:transplantation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal / Q000009:adverse effects; D007828:Laryngoscopy; D007829:Laryngostenosis / Q000151:congenital / Q000209:etiology / Q000601:surgery*; D053685:Laser Therapy; D008297:Male; D012189:Retrospective Studies; D012272:Ribs; D014135:Tracheal Stenosis / Q000151:congenital / Q000209:etiology / Q000601:surgery*; D014140:Tracheotomy / Q000009:adverse effects
Les sténoses laryngo-trachéales de l'enfant. Aspects actuels du traitement chirurgical et de leur prévention.