Subglottic Stenosis in the Pediatric Patient: A Review of Current Management

Jeremy      D. Meier; David      R. White

Abstract

The surgical options for children with subglottic stenosis (SGS) have evolved from primarily tracheotomy fifty years ago to open and endoscopic techniques today. Improved airway management in the neonatal intensive care unit and better understanding of gastroesophageal reflux and its impact in the neonatal airway have decreased the overall incidence of subglottic stenosis. However, SGS remains a significant cause of morbidity in the neonatal population. Laryngotracheal reconstruction with cartilage grafting is the most common treatment for moderate subglottic stenosis. Cricotracheal resection is a more extensive operation but has achieved excellent results in children with severe subglottic stenosis. Developing endoscopic airway techniques using instruments such as balloon dilators, carbon dioxide lasers, and microdebriders, continue to expand the surgeon's armamentarium in treating subglottic stenosis. This paper reviews the evaluation and management of subglottic stenosis with an emphasis on discussing current surgical techniques.

Keywords: Cricotracheal resection, laryngotracheal reconstruction, subglottic stenosis, fiberoptic laryngoscopy, Microlaryngoscopy, bronchoscopy

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