Management of severe congenital tracheal stenosis.
We have managed 23 infants and children with severe tracheal stenosis due to congenital complete tracheal rings producing a long-segment stenosis of the trachea. Nineteen (83%) have survived this life-threatening cause of airway obstruction, 7 of whom also had pulmonary artery slings. Pericardial patch tracheoplasty facilitated by partial cardiopulmonary bypass is currently our preferred technique for surgical repair. Eighteen patients (78%) underwent operative intervention, 3 of whom (17%) have died since surgery. The mean follow-up is 4.5 years. Bronchoscopy is essential for preoperative diagnosis and accurate intraoperative incision of the trachea, and is critical for long-term postoperative airway management. The more distal lesions are associated with increased complications and a higher mortality rate.
Dunham
M E
ME
Division of Pediatric Otolaryngology, Children's Memorial Hospital, Chicago, Illinois 60614.
Holinger
L D
LD
Backer
C L
CL
Mavroudis
C
C
D000402:Airway Obstruction / Q000401:mortality / Q000601:surgery; D001999:Bronchoscopy; D002315:Cardiopulmonary Bypass; D002356:Cartilage / Q000637:transplantation; D003646:Debridement; D004106:Dilatation; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011182:Postoperative Care; D011651:Pulmonary Artery / Q000002:abnormalities / Q000000981:diagnostic imaging; D012272:Ribs; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000002:abnormalities / Q000601:surgery*; D014135:Tracheal Stenosis / Q000151:congenital* / Q000401:mortality / Q000601:surgery*