[Surgical treatment of laryngotracheal stenosis in childhood].
Acquired or congenital laryngotracheal stenosis is uncommon in children although premature infants with respiratory distress syndrome (SDR) requiring ventilatory support with prolonged intubation are at great risk. The different treatments used in the past show high rates of morbidity and mortality. Following the technique described by Cotton in 1980, anterior cricoid slit procedure in the upper two tracheal rings has been used as a primary treatment on five patients since 1991, four by intrinsic stenosis and one by extrinsic. Extubation failed in four of them, checking trough bronchoscopy different grades of laryngotracheal stenosis and in the fifth due to respiratory distress, secondary to subcricoid stenosis. Anterior cricoid split procedure with intubation with conventional endotracheal tube (SET) or Montgomery tube (TTM) was performed on infants whose ages ranged from 4 to 18 months old (averaged 8 months). They were extubated between the 5th and 340th days after surgery. Two of them underwent complications: a skin-tracheal fistula and a paresis of the left vocal cord, the two are asymptomatic after four and eighteen months of the procedure. All patients discharged without signs of upper airway obstruction, except one who developed a granuloma which diminished with cortisone. Anterior cricoid split with prolonged intubation is a safe and useful technique for the treatment of laryngotracheal stenosis.
Uroz-Tristán
J
J
Servicio de Cirugía Pediátrica, Hospital Materno Infantil, Las Palmas de Gran Canaria.
Sanchís Solera
L
L
Benítez del Rosario
J
J
Martínes Sopena
J
J
Alonso Jiménez
L
L
López-Pinto
J
J
García Urgellés
X
X
D000367:Age Factors; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D007829:Laryngostenosis / Q000601:surgery*; D011183:Postoperative Complications; D013997:Time Factors; D014135:Tracheal Stenosis / Q000601:surgery*
Tratamiento quirúrgico de las estenosis laringotraqueales en la infancia.