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At least 19 recordsLinked to original sources
PubMed1976

Division of posterior cricoid plate in young children with subglottic stenosis.

Subglottic stenosis was corrected surgically in three young children. The key surgical maneuver is the anterior and posterior division of the cricoid cartilage. Endoscopic, xerographic and speech assessments have been done at intervals since decannulation. The anterior commissure is widened and the endolarynx deformed in two children examined. Radiographic studies indicated that increased airway diameters have been maintained to date. Speech has been adversely affected to some degree in all three patients.

Child, Preschool↗
PubMed1975

The roentgenologic investigation of congenital subglottic stenosis.

Congenital subglottic stenosis, which is life-threatening to the infant, can be diagnosed by the correlation of the clinical and the roentgenologic findings. The main clinical sign is the persistence of stridor from birth. The indicative roentgenologic finding is a symmetrical narrowing of the subglottic segment which is constant in form and length during the various phases of the respiratory cycle. Two cases are presented, one confirmed by postmortem examination and the other by endoscopy. The etiology of this condition and the differential diagnosis are discussed.

Female↗
PubMed1979

Histopathology of congenital subglottic stenosis.

Three patients with congenital subglottic stenosis are presented and whole organ serial-section studies of their larynges are discussed. A superiorly displaced first tracheal ring is observed to form a cartilaginous subglottic stenosis in one. This "trapped first ring" is demonstrated in horizontal, sagittal and coronal planes. Subglottic stenosis is a clinical diagnosis which describes multifarious histopathological forms of narrowing within the subglottic larynx.

Cricoid Cartilage↗
PubMedDate not supplied

Experimental animal model of subglottic stenosis.

An animal model of subglottic stenosis has been developed. The results of this pilot study show evidence to suggest that injury to the cricoid cartilage leading to perichondritis is the important factor in the development of subglottic stenosis.

Animals↗
PubMed2026

Whole genome sequencing reveals a specific microbiota in subglottic stenosis C. acnes may contribute to inflammation.

PURPOSE: Subglottic stenosis (SGS) progressively reduces the airway below the vocal folds. The cause is not known and there is a recurrent need of surgical treatment. Including all phenotypes, SGS affects 1/400 000/yr, with a female dominance. Previous studies have revealed a possible role of the Mycobacterium complex in SGS development. Our hypothesis is that microbiota is associated with the inflammation in SGS, if true it might affect the prevailing treatment options. METHODS: This prospective cross-sectional study included biopsies from 34 patients with subglottic stenosis, collected between 2020 and 2023. Nucleic acids were extracted from the tissue samples and analysed using whole genome sequencing. Microbial composition was characterized using taxonomic profiling of sequencing data. Species with sufficient read counts were selected for further validation using sequence alignment methods to ensure accuracy of identification. RESULTS: Using the most comprehensive form of genomic testing currently in clinical use, we present curated and stable data on the presence of Cutibacterium acnes in 28 out of the 34 cases. CONCLUSION: Cutibacterium acnes may serve as a driver of the inflammation characterizing SGS and should be considered in therapeutically oriented future studies.

Cutibacterium acnes↗
PubMedDate not supplied

Idiopathic subglottic stenosis.

A 2 1/2-year-old child was found to have subglottic stenosis with no obvious etiology. He initially responded well to dilatation, injection of triamcinolone and intermittent stenting of the airway, but four months later developed a marked, unyielding subglottic stenosis requiring tracheostomy. He had a gradual good response to dilatations and injections with triamcinolone and acquired a good subglottic lumen. However, he developed a recurrence following an episode of croup. Systemic steroids were added to the regimen leading to gradual resolution of the stenosis and successful decannulation. The embryogenesis of subglottic stenosis and the correlation with the known anatomy and histology are discussed. Subglottic stenosis may be congenital, traumatic, inflammatory, neoplastic or neurogenic. An additional group of patients has no obvious etiology and are classified as idiopathic. Treatment consists of various combinations of stents, systemic and intralesional steroids, dilatations and various operative procedures in the more refractory cases.

Airway Obstruction↗
PubMed1979

Intralesional steroids in conservative management of subglottic stenosis of the larynx.

Subglottic stenosis after prolonged endotracheal intubation is a well recognised complication, especially with the advent of intensive resuscitative techniques. Although prevention is the best cure, once the management has been established it should be conservative in the first instance, especially in the case of children. The successful treatment of four cases with this complication is reported. The treatment consisted of intralesional injection of Triamcinolone Acetonide Aqueous Suspension (Kenacort A), dilatation with gum elastic bougies, bronchoscopy and very limited surgical correction in one case. A brief reference is made to the etiological factors and to the mechanism of action of steroids in scar tissue.

Adult↗
PubMed1978

Surgical repair of complete subglottic stenosis.

Two cases of complete subglottic stenosis, with absence of any subglottic airway, are presented. Both patients were treated via an anterior tracheo-crico-thyrotomy with excision of scar tissue. In both patients the newly created lumen was stented with Silastic covered with a buccal graft. One of these patients also had a hyoid bone autograft inserted between the cut edges of the cricoid ring. Both patients were successfully decannulated. The literature is reviewed in order to trace the history of the development of the procedures used.

Adolescent↗
PubMedDate not supplied

Acquired and congenital subglottic stenosis in the infant.

During the calendar year of 1974, the Intermountain Newborn Intensive Care Center at the University of Utah Medical Center had 603 admissions. A representative group of 293 charts were reviewed which indicated that 44% of these children were intubated from hours to weeks. The overall mortality rate for the 293 children was 29%. Eighteen of the 603 children were diagnosed as having subglottic stenosis. Fifteen of these children appeared to have acquired subglottic stenosis secondary to endotracheal intubation. Three children had congenital subglottic stenosis. Tracheostomy was necessary in the management of 15 patients. Ten of the 18 patients have survived and two of these patients still have tracheostomy tubes in place. The survival and thickness of the stenotic area are inversely proportional to the birth weight and the duration of intubation. Endoscopic excision, dilatation and stenting were techniques utilized in the treatment of these stenotic lesions. The extubation technique utilized is described. The factors involved in the production of acquired subglottic stenosis are presented along with suggestions to decrease the incidence of this problem in the intubated child.

Glottis↗
PubMedDate not supplied

Subglottic stenosis in infants and children.

Of 158 cases of subglottic stenosis 115 were congenital and 43 acquired. Current follow-up has been obtained in 146 (92%) which constitutes the determinate group. Although stridor was the most common presenting symptom of the congenital group, 34% presented with recurrent or prolonged episodes of croup. Tracheotomy was required in 47 of the 107 determinate cases (44%). Further management of the congenital cases was based on the experience that children outgrow this disorder; periodic dilatation may augment the natural process. Of those infants and children tracheotomized, all but five have been decannulated, and there was one death - a mortality rate of 2.1%. Acquired subglottic stenosis proved to be a more difficult management problem. Tracheotomy was necessary in 38 of the 39 determinate cases (97%). Repeated active dilatations for prolonged periods were usually required as well as endoscopic removal of granulation tissue. Of those infants and children tracheotomized, all but eight have been decannulated. There were nine deaths; five were due to unrelated underlying disease; four were attributable to complications of long-term tracheostomy. Thus, in the entire series, 85 infants and children required tracheotomy and five deaths may be attributable to long-term tracheostomy complications - a mortality rate of 5.9%.

Child↗
PubMedDate not supplied

Management of subglottic stenosis in infancy and childhood. Review of a consecutive series of cases managed by surgical reconstruction.

The management of mature subglottic stenosis secondary to endotracheal intubation in infancy and childhood remains a controversial issue. If treated similarly to congenital subglottic stenosis by tracheotomy and a "wait-and-see" period then there is a considerably higher mortality and morbidity for the acquired disease compared with the congenital. Eighteen children with severe acquired subglottic stenosis managed by surgical reconstruction are presented; 17 have been successfully extubated. The longest follow-up is 5 1/2 years. No evidence of interference with laryngeal growth is evident.

Adolescent↗
PubMed1979

Therapy of iatrogenic subglottic stenosis: a steroid/antibiotic regimen.

The authors have evaluated the efficacy of a medical regimen, consisting of systemic antibiotics and steroids, in the management of acute iatrogenic subglottic stenosis. The study consisted of the infliction of a standardized subglottic injury to three groups of five dogs: Group I animals were placed on prednisone 1 mg/kg/24 hours and potassium phenoxymethyl penicillin 50 mg/kg/24 hours from the day of the trauma. Group II were placed on a similar regimen from the eighth day after subglottic trauma. Group III received no medical therapy at all. Therapy was continued in treated Groups I and II for five weeks. At the end of the study the dogs were sacrificed and the final degree of subglottic stenosis evaluated, at which time the laryngotracheal complexes were submitted for pathological evaluation. A significant difference was found between the degree of stenosis attained in the three groups. The study suggests that the introduction of a steroid/antibiotic regimen has a beneficial effect in developing subglottic stenosis and that the timing of such therapy is of importance.

Aged↗
PubMed1976

Extended laryngofissure in the management of subglottic stenosis in the young child: a preliminary report.

The child with subglottic stenosis and a tracheotomy is a management problem. To date, a consistent method for successful and expeditious correction of the primary lesion to permit decannulation has eluded clinicians. The child is tracheotomized and thus frequently hospitalized for a lengthy period. Personal development and family relationships are adversely affected and the mortality rate during this period of cannulation is significant. During the past eighteen months in an attempt to achieve earlier decannulation, three children with subglottic stenosis have undergone a surgical procedure in which division of the anterior and posterior aspects of the cricoid ring are the key surgical maneuvers.

Child, Preschool↗
PubMed1978

Laryngotracheoplasty for acquired subglottic stenosis in infants and children: experience with six cases.

Six children aged 6-50 months with acquired subglottic stenosis persisting after medical and endoscopic treatment underwent 7 open resections of the stenotic tissue followed by internal stenting. Five were successfully decannulated after an average treatment time of 6.8 months; the sixth died after accidental extubation. All 5 have satisfactory vocal and respiratory function 11 to 36 months postoperatively (6-18 months postextubation). Transcartilaginous open resection of subglottic stenosis is a feasible treatment option which can be used, even in the infant, when expectant observation is not advisable.

Child, Preschool↗
PubMedDate not supplied

Nontraumatic, nonneoplastic subglottic stenosis.

During a 20-year period, 12 patients with nontraumatic, nonneoplastic subglottic stenosis were seen at the Mayo Clinic. The etiologic factors were relapsing polychondritis, amyloidosis, sarcoidosis, and Wegener's granulomatosis. Because of the diverse initial presentation of the disease, the clinician should consider that the stenosis is a manifestation of a systemic disorder and carry out an otolaryngologic and physical examination with the appropriate roentgenograms and blood and urine tests. Treatment, if a systemic disease is proved, consists of appropriate medication. Surgery may be necessary, depending on the nature of the lesion. Small strictures may not need to be treated.

Adolescent↗
PubMed1976

Surgical correction of subglottic stenosis of the larynx. Clinical results of the Fearon-Cotton operation.

Thirty-five cases of subglottic stenosis were treated by one of the authors during the 6-1/2 year period January 1970 to June 1976 inclusive. Six of these failed to respond to routine management by repeated dilatation or were considered unlikely to do so. These cases were treated by a new operation, the experimental aspects of which have been previously described. Two of the six cases have been successfully extubated and two others will be so in the near future. An analysis of the problems encountered and some possible solutions are presented, as is a brief description of the operative procedure. The carbon dioxide gas laser would appear to have an important part to play in the management of glottic and subglottic webs, but its value has yet to be proven.

Cartilage↗
PubMedDate not supplied

Long-term stenting in the treatment of subglottic stenosis.

Long-term stenting (3 to 12 months) with silicone rubber stents was found successful in 12 of 14 cases (86%) with severe subglottic stenosis. A new silicone rubber stent is described that is suitable for long-term stenting in infants or adults.

Adult↗