Pediatric dyspnea caused by supraglottic stenosis: a rare complication of alkali corrosive injury.
Acquired supraglottic stenosis is a rare, but potential late sequela of corrosive injury, usually occurring 1 to 2 months after the initial trauma. The presentation may be delayed in children and is potentially lethal. We describe two pediatric patients, aged 31 and 16 months, who developed progressive inspiratory stridor and hoarseness about 2 months after accidental alkali ingestion. Fiberoptic laryngoscopy showed supraglottic stenosis. Intubation was achieved with a very small endotracheal tube under fiberoptic laryngobronchoscopic guidance prior to general anesthesia. Both patients successfully underwent CO(2) laser treatment under direct laryngoscopic guidance. There has been no case of recurrence reported after 1 year of follow-up other than a thin membranous scar in one case at the 3rd month of follow-up, which was easily dealt with by bronchoscopy dilatation. For such patients, monthly laryngoscopic examinations are advisable after alkaline corrosive injury for a minimum of 6 months. Prompt diagnosis and early airway intervention can reduce the need for tracheostomy and decrease the mortality rate.
Chen
Yi-Wei
YW
Department of Otolaryngology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Lai
Shen-Hao
SH
Fang
Tuan-Jen
TJ
Li
Hseuh-Yu
HY
Lee
Ta-Jen
TJ
D000468:Alkalies / Q000009:adverse effects*; D002057:Burns, Chemical / Q000150:complications*; D002245:Carbon Dioxide; D002675:Child, Preschool; D004417:Dyspnea / Q000209:etiology*; D006801:Humans; D007223:Infant; D007828:Laryngoscopy; D007829:Laryngostenosis / Q000139:chemically induced* / Q000150:complications / Q000601:surgery; D053685:Laser Therapy; D008297:Male
D000468:Alkalies; D002245:Carbon Dioxide