Supraglottic stenosis in infants and children. A preliminary report.
OBJECTIVE
To describe a condition identified in the pediatric population that narrows the supraglottic larynx. This condition has been termed supraglottic stenosis/collapse. To discuss common factors present in these children and to examine potential causes of this specific condition.


METHODS
Retrospective review of patients with supraglottic stenosis/collapse from October 1985 to June 1993.


METHODS
Academic tertiary care children's hospital.


METHODS
Seventeen patients aged 7 months to 14 years underwent laryngoscopy and bronchoscopy for evaluation or follow-up of upper airway obstruction or respiratory failure and were found to have supraglottic stenosis/ collapse.


METHODS
Each patient's records were reviewed for the average age at the time of diagnosis, history of prematurity, evidence of gastroesophageal reflux, history of long-term intubation, and any associated medical problems. In addition, patients were compared based on previous airway surgery (tracheostomy, laryngotracheal reconstruction, or anterior cricoid split).


RESULTS
Chronic upper airway obstruction was identified in 17 patients caused by supraglottic stenosis/ collapse. All patients (100%) had undergone tracheostomy prior to the recognition of supraglottic stenosis/ collapse. Fifty-nine percent of the patients had undergone laryngotracheal reconstruction, and 53% had a history of gastroesophageal reflux.


CONCLUSIONS
Supraglottic stenosis/collapse is a distinct entity that may be related to prior laryngeal or tracheal surgery. This diagnosis should be considered when evaluating and treating patients with chronic upper airway obstruction following laryngeal and/or tracheal surgery.
Walner
D L
DL
Children's Hospital Medical Center, Department of Pediatric Otolaryngology, Cincinnati, Ohio, USA.
Holinger
L D
LD
D000293:Adolescent; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D005931:Glottis; D006801:Humans; D007223:Infant; D007828:Laryngoscopy; D007829:Laryngostenosis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D007830:Larynx / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis; D012189:Retrospective Studies; D014132:Trachea / Q000601:surgery; D014139:Tracheostomy