Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “LARYNGOSTENOSIS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources
PubMed1985

Prevention and management of laryngeal stenosis in infants and children.

Acquired laryngeal stenosis is a well-documented complication of endotracheal intubation. Premature infants requiring ventilatory support for respiratory distress syndrome are at increased risk for developing laryngeal stenosis. Until recently, the techniques for repair of laryngeal stenosis have required a temporary tracheotomy which complicates the management and has an associated mortality. In 1980 the use of an anterior cricoid split was described to treat laryngeal stenosis in infants. The technique has been modified: the anterior cricoid split procedure as originally described required a single midline vertical incision through the anterior cartilaginous ring of the cricoid cartilage and the upper 2 tracheal rings; the modification is an extension of the superior limit of the incision in the thyroid cartilage to within 2 mm of the thyroid notch. The technique has been used in 45 children whose ages range from 4 days to 28 months. In addition to being of value for the treatment of laryngeal stenosis in premature infants (29 patients), 2 other clinical groups of children who benefit from the produce have been identified; 11 infants who developed laryngeal stenosis in the first 2 years of life secondary to intubation and in whom the anterior cricoid split was used as an alternative to tracheotomy; 5 infants under 2 years of age, each with a tracheotomy for laryngeal stenosis in whom the anterior cricoid split was used as an alternative to more extensive methods of laryngotracheal reconstruction. Of the premature infants (29), 18 were successfully extubated, 5 still required a tracheotomy, and 6 died before extubation was accomplished; the predominant cause of death was respiratory failure secondary to the underlying bronchopulmonary dysplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1985

The anterior cricoid split procedure for the management of subglottic stenosis in infants and children.

Severe acquired subglottic stenosis occurs most commonly in infants and children who require long-term ventilatory support with indwelling endotracheal tubes for underlying respiratory disease. A variety of operative and endoscopic procedures have been advocated for this problem including endoscopic fulguration, cryotherapy, direct incision or excision, and several types of extensive direct laryngotracheoplasties. The failure rate with these procedures is high. We have treated 22 patients including 12 neonates and 10 older children with acquired airway injury and obstruction with a simple cricoid split. In 15 patients the airway obstruction was completely relieved and these youngsters were extubated without difficulty. An additional 3 patients failed initial extubation which was subsequently successful, however, after repeat intubation for a short period of time. Endoscopic follow-up shows complete healing of the incised area. In 2 neonates the procedure was unsuccessful, and tracheotomy was needed. One of these had additional severe airway injury in the distal tracheobronchial tree secondary to selective bronchial intubation in the newborn period. Two older children also required tracheotomy because of severe airway scarring unrelieved by this procedure. The cricoid split is a simple and successful way of dealing with subglottic stenosis, especially in the newborn premature infant. A significant advantage is that it disturbs the anatomy very little, allowing for more extensive laryngotracheoplasty in the future should it fail.

Age Factors↗
PubMed1987

Anterior cricoid split for subglottic stenosis.

Subglottic stenosis is a common problem that often results from ventilatory support necessary in the premature infant. Previous methods of treatment include tracheostomy with dilatation of the stenosis, steroid injections, and procedures to stent the trachea. Results of these methods have been unsatisfactory because of the multiple procedures needed to obtain an adequate airway as well as the high mortality from long-term tracheostomy in infants. In the past 2 years, seven infants have undergone an anterior cricoid split for tight subglottic stenosis and airway obstruction. Of the seven patients, six were premature, five of whom required ventilatory support ranging from 4 to 30+ days. Each child presented in respiratory distress with symptoms present in five children from 1 to 11 months (mean 3.8) after birth. Bronchoscopy identified the site of obstruction in each case as subglottic, with a narrow lumen, usually less than 2.5 mm in diameter. Anterior cricoid split was performed at ages ranging from 2 to 11 months (mean 5.0). All children were extubated at 10 to 14 days and subsequently discharged home asymptomatic; none required postoperative tracheostomy. Complications developed in five children, including atelectasis, otitis media, phlebitis, and tracheocutaneous fistula in two, one of whom required operative closure. One child was rebronchoscoped at 3 weeks postoperatively for bronchospasm, which resolved on aminophylline. The subglottic trachea was normal. At follow-up ranging from 2 to 21 months (mean 8.3), no child has symptoms referrable to the subglottic region. In one patient, a brief period of respiratory distress recurred 3 months postoperatively due to tracheomalacia.(ABSTRACT TRUNCATED AT 250 WORDS)

Cricoid Cartilage↗
PubMed1993

Wegener granulomatosis in children and adolescents: clinical presentation and outcome.

We prospectively studied and compared clinical features, treatment, course of illness, and long-term morbidity and mortality rates for Wegener granulomatosis in 23 childhood-onset patients with those of 135 adult-onset patients who were studied concurrently. Treatment was usually provided with glucocorticoids and cyclophosphamide. The mean follow-up period was 8.7 years for childhood-onset and 7.6 years for adult-onset Wegener granulomatosis. Most aspects of Wegener granulomatosis were similar in childhood-onset and adult-onset patients. Permanent morbidity from disease occurred in 86% of both groups. However, some features were significantly different. Wegener granulomatosis in childhood-onset patients was complicated five times more often by subglottic stenosis and twice as often by nasal deformity. Treatment-related permanent morbidity occurred in 22% of childhood-onset patients and 45% of adult-onset patients. After similar periods of cyclophosphamide therapy and follow-up, cyclophosphamide-related malignancies were less likely (0% vs 11%) to have developed in childhood-onset patients. Although 89% of patients treated with glucocorticoids and cyclophosphamide had remission, prolonged delay in achieving remission and relapses led in both patient groups to freedom from active disease for approximately 50% of the total patient-years. As a result, morbidity was substantial and has led to comparative studies of alternative therapies.

Adolescent↗
PubMed1986

Factors influencing acquired subgottic stenosis in infants.

A prospective study of factors that might contribute to the development of acquired subglottic stenosis was undertaken in newborn infants with endotracheal tubes in place for 7 days or more. Duration of intubation, the number of endotracheal tubes inserted, the duration of mechanical ventilation, the presence of post-extubation stridor, and the size of the endotracheal tube in relation to gestational age significantly correlated with the development of subglottic stenosis. Patients at risk for significant subglottic stenosis were those with post-extubation stridor and those with tubes in place for 25 days or longer. On the basis of these findings, it is recommended that endotracheal tubes be chosen such that the ratio of nominal tube size divided by the patient's gestational age in weeks is less than 0.1.

Birth Weight↗
PubMed1997

Temporary prosthesis for laryngotracheal stenosis: a clinical report.

Clinical and laboratory procedures to fabricate a transitional prosthesis for patients treated with laryngofissure surgery have been described. Hard resin promoted healing of the surgical area and maintained the opening because of its stiffness. The prosthesis, which can be highly polished, was easily removed by the patient for proper hygiene and was fabricated to accurately fit the inside margins of the wound. All these factors were important for a good clinical result.

Humans↗
PubMed1996

Subglottic stenosis complicating Wegener's granulomatosis: surgical repair as a viable treatment option.

Wegener's granulomatosis frequently involves the subglottis and trachea, often leading to compromise of the upper airway. Moreover, the stenotic segments may persist or progress despite control of the disease elsewhere in the body. In this report, we describe the cases of five patients with Wegener's granulomatosis who, in addition to nasal, sinus, pulmonary and renal involvement, had symptomatic subglottic or tracheal stenosis. Biopsy specimens from involved sites in the subglottis and trachea were often not diagnostic, and the diagnosis was later confirmed by a positive antineutrophil cytoplasm antibody titer. All patients had clinical remission on standard therapeutic regimens with prednisone and cyclophosphamide but continued to have symptoms of extrathoracic airway obstruction. Three of the five patients underwent primary thyrotracheal anastomosis while their disease was in clinical remission, without postoperative compromise of anastomotic integrity or wound healing despite concurrent use of prednisone and cyclophosphamide. There has been no evidence of local disease recurrence during follow-up periods ranging from 3 months to 14 years. We conclude that surgical intervention is a viable treatment option for patients who have symptomatic stenotic segments of the subglottis and trachea as a result of Wegener's granulomatosis in clinical remission.

Adult↗
PubMed1989

Tracheopathia osteoplastica: familial occurrence.

Tracheopathia osteoplastica is an unusual disease characterized by cartilaginous or bony projections into the tracheobronchial lumen, with sparing of the posterior membranous portion of the tracheobronchial tree. The cause of this disorder is unknown. The diagnosis is seldom made because of the chronic and asymptomatic nature of the condition. More than 90% of the cases are diagnosed at postmortem examination. Symptoms may include dyspnea, coughing, hemoptysis, hoarseness, and wheezing. Tomography of the trachea may reveal beaded calcification of the tracheobronchial cartilages. Bronchoscopy is diagnostic. Histologically, the abnormal growths show heterotopic bone formation. No known treatment is available. We describe two female patients, one with hemoptysis and another with asthmalike symptoms, in both of whom bronchoscopy established the diagnosis of tracheopathia osteoplastica. The first patient had recurrent episodes of pneumonia attributable to bronchial obstruction by bony projections. In the second patient, removal of large lesions that obstructed the upper part of the trachea relieved the dyspnea. Of interest is the fact that the first patient was the biologic mother of the second. To our knowledge, this constitutes the first report of familial occurrence of tracheopathia osteoplastica.

Aged↗
PubMed2000

Management of subglottic stenosis.

Evaluation and management of pediatric subglottic stenosis is complex and technically challenging. Laryngotracheal reconstruction has become the standard of care for symptomatic subglottic stenosis in children. Careful preoperative planning, meticulous surgery, and dedicated postoperative care are essential for a successful outcome. Early recognition and management of intraoperative and postoperative complications minimize their impact.

Child↗
PubMed2000

Posterior glottic stenosis and bilateral vocal fold immobility: diagnosis and treatment.

Posterior glottic stenosis and bilateral vocal fold immobility cause obstruction of the airway at the glottis. Presentation of this problem may vary according to the cause. Full evaluation of the status of the larynx is crucial with regard to the mobility of the arytenoid cartilage and innervation of the laryngeal musculature. There are many techniques for surgically treating this condition, each with advantages and disadvantages. The surgeon should be familiar with a variety of these procedures and be able to adapt to each patient's situation.

Glottis↗
PubMed1996

Assessment and management of laryngotracheal stenosis.

Laryngotracheal stenosis should be suspected in children with recurrent, prolonged, or atypical croup; a history of endotracheal intubation; or a history of stridor, feeding difficulties, and failure to thrive. Tracheotomy-dependent patients with acquired laryngotracheal stenosis are candidates for surgical intervention to provide the child with the earliest opportunity to develop normal oral communication.

Child↗
PubMed1984

Anatomic abnormalities of the pediatric airway.

The physician who is called upon to evaluate stridor in the infant or child must be familiar with common congenital lesions of the airway, the symptoms they produce, and methods for their diagnosis and treatment. The authors discuss some of the more common anomalies and review the guidelines for their diagnosis and treatment.

Airway Obstruction↗