- Minimally invasive treatment of airway stenoses in children
Minimally invasive treatment of airway stenoses in children
PERINATOLOGY AND PEDIATRIC. UKRAINE. 2018.1(73):118-124; doi 10.15574/PP.2018.73.118
Krivchenya D. U., Rudenko E. O., Dubrovin A. G.
Bogomolets National Medical University, Kyiv, Ukraine
National Children's Specialized Hospital «OKHMATDYT», Kyiv, Ukraine
Objective. To evaluate the efficacy of minimal invasive methods in airway stenosis treatment in children.
Material and methods. A retrospective study of patients with congenital or acquired subglottic laryngotracheal stenosis, congenital tracheal stenosis due to complete cartilaginous rings, and congenital stenosis of the intermediate bronchus, who underwent at least one session of endoscopic treatment, was conducted.
Results. The study included 41 patients aged 3 weeks to 15 years (22.6±6.2 months), 24 (58.5%) children were under 1 year of age. In 11 patients congenital subglottic stenosis was diagnosed, 23 patients had postintubation subglottic stenosis, in 4 cases there was congenital tracheal stenosis due to full cartilaginous rings, and in 3 — congenital stenosis of the intermediate bronchus. The minimally invasive endoscopic procedures as primary treatment were performed in 39 (95.1%) patients. In 6 cases they were supplemented with surgical correction. In the case of laryngotracheal stenosis of I, II and III grade, the effectiveness of the primary application of minimally invasive methods was 100%, 86.4% and 40%, respectively, and in the case of complete cartilage rings and stenosis of the intermediate bronchus — 100%.
Conclusions. The overall rate of positive results of the initial application of minimally invasive methods for correction of airway stenoses is 84.6%, which corresponds to the modern literature data.
Key words: airways, stenosis, minimal invasive treatment.
1. Ang AH, Modi VK, Raithatha R et al. (2010). A pilot study of balloon dilation in an animal model resulting in cricoid cartilage fracture: implications for the stenotic pediatric airway. Laryngoscope. 120(10): 2094—2097. https://doi.org/10.1002/lary.21066
2. Anton-Pacheco JL, Cano I, Garcia A et al. (2003). Patterns of management of congenital tracheal stenosis. J Pediatr Surg. 38(10):1452—1458. https://doi.org/10.1016/S0022-3468(03)00495-0
3. Anton-Pacheco JL, Morante R. (2017). Operative or non-operative treatment of congenital tracheal stenosis: is there something new?. J Thorac Dis. 9(12): 4878—4880. https://doi.org/10.21037/jtd.2017.11.75
4. Backer CL, Holinger LD. (2010). A History of Pediatric Tracheal Surgery. World Journal for Pediatric and Congenital Heart Surgery. 1(3):344—363. https://doi.org/10.1177/2150135110381602
5. Baker S, Kelchner L, Weinrich B et al. (2006). Pediatric laryngotracheal stenosis and airway reconstruction: a review of voice outcomes, assessment, and treatment issues. Journal of Voice. 20(4):631—641. https://doi.org/10.1016/j.jvoice.2005.08.012
6. Bakthavachalam S, McClay JE. (2008). Endoscopic management of subglottic stenosis. Otolaryngology-Head and Neck Surgery. 139(4):551—559. https://doi.org/10.1016/j.otohns.2008.07.024
7. Beddow E, Rice AJ, Sheppard MN et al. (2004). Idiopathic tracheal and bronchial stenosis in two pediatric patients. Ann Thorac Surg. 77(5):1829—1832. https://doi.org/10.1016/j.athoracsur.2003.05.001
8. Boardman SJ, Albert DM. (2008). Single-stage and multistage pediatric laryngotracheal reconstruction. Otolaryngol Clin N Am. 41(5):947—958. https://doi.org/10.1016/j.otc.2008.04.002
9. Cheng W, Manson DE, Forte V et al. (2006). The role of conservative management in congenital tracheal stenosis: an evidence-based longterm follow-up study. J Pediatr Surg. 41(7):1203—1207. https://doi.org/10.1016/j.jpedsurg.2006.03.046
10. Durden F, Sobol SE. (2007). Balloon laryngoplasty as a primary treatment for subglottic stenosis. Arch Otolaryngol Head Neck Surg. 133(8): 772—775. https://doi.org/10.1001/archotol.133.8.772
11. Grillo HC. (2004). Congenital and acquired tracheal lesions in children. In: HC Grillo (Editor). Surgery of the Trachea and Bronchi (pp.173—205). Hamilton London: BC Decker.
12. Guarisco JL, Yang CJ. (2013). Balloon dilation in the management of severe airway stenosis in children and adolescents. J Pediatr Surg. 48(8):1676—1681. https://doi.org/10.1016/j.jpedsurg.2012.12.035
13. Hautefort C, Teissier N, Viala P et al. (2012). Balloon dilation laryngoplasty for subglottic stenosis in children: eight years' experience. Arch Otolaryngol Head Neck Surg. 138(3):235—240. https://doi.org/10.1001/archoto.2011.1439
14. Herrera P, Caldarone C, Forte V et al. (2007). The current state of congenital tracheal stenosis. Pediatric surgery international. 23(11):1033—1044. https://doi.org/10.1007/s00383-007-1945-3
15. Lando T, April MM, Ward RF. (2008). Minimally invasive techniques in laryngotracheal reconstruction. Otolaryngol Clin N Am. 41(5): 935—946. https://doi.org/10.1016/j.otc.2008.04.007
16. Liew YT, Yong DJ, Somasundran M, Lum CL. (2015). Management Experience of Subglottic Stenosis by Endoscopic Bougie Dilatation with Mitomycin C and Review of Literature: Case Series. Indian Journal of Otolaryngology and Head & Neck Surgery.67.1:129—133. https://doi.org/10.1007/s12070-014-0801-8; PMid:25621268 PMCid:PMC4298622
17. Maeda K, Ono S, Tazuke Y et al. (2013). Long-term outcomes of congenital tracheal stenosis treated by metallic airway stenting. J Pediatr Surg. 48(2):293—296. https://doi.org/10.1016/j.jpedsurg.2012.11.002
18. Monnier P. (2011). Pediatric Airway Surgery. Management of Laryngotracheal Stenosis in Infants and Children. Berlin Heidelberg: SpringerVerlag.390p. https://doi.org/10.1007/978-3-642-13535-4
19. Munzon GB, Martinez-Ferro M. (2012). Pediatric tracheal stenosis and vascular rings. Toraks Cerrahisi B?lteni. 3:206-219. https://doi.org/10.5152/tcb.2012.30
20. Myer III CM, O'Connor DM, Cotton RT. (1994). Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol. 103(4): 319-323. https://doi.org/10.1177/000348949410300410
21. Quesnel AM, Lee GS, Nuss RC et al. (2011). Minimally invasive endoscopic management of subglottic stenosis in children: success and failure. Int J Pediatr Otorhinolaryngol. 75(5):652—656. https://doi.org/10.1016/j.ijporl.2011.02.002
22. Rizzi MD, Thorne MC, Zur KB et al. (2009). Jacobs IN. Laryngotracheal reconstruction with posterior costal cartilage grafts: outcomes at a single institution. Otolaryngology_Head and Neck Surgery. 140(3):348—353. https://doi.org/10.1016/j.otohns.2008.11.035
23. Rutter MJ, Cohen AP, de Alarcon A. (2008). Endoscopic airway management in children. Current opinion in otolaryngology & head and neck surgery. 16(6):525—529. https://doi.org/10.1097/MOO.0b013e3283184479
24. Rutter MJ, Prosser JD, deAlarc?n A. (2015). Congenital tracheal stenosis. In J Lioy, S Sobol (Eds). Disorders of the Neonatal Airway (pp. 81—86). New York: Springer.
25. Shah RK, Lander L, Choi SS et al. (2008). Resource utilization in the management of subglottic stenosis. Otolaryngology-Head and Neck Surgery. 138(2):233—241. https://doi.org/10.1016/j.otohns.2007.10.015
26. Smith LP, Zur KB, Jacobs IN. (2010). Single-vs double-stage laryngotracheal reconstruction. Archives of Otolaryngology-Head & Neck Surgery. 136(1): 60—65. https://doi.org/10.1001/archoto.2009.201; PMid:20083780
27. Whigham AS, Howell R, Choi S et al. (2012). Outcomes of balloon dilation in pediatric subglottic stenosis. Ann Otol Rhinol Laryngol. 121(7):442—448. https://doi.org/10.1177/000348941212100704