Abstract
Tracheal stenosis of newborn infants and children is often noted in subglottic cricoid cartilage. A cleft lip alveolus patient with subglottic tracheal stenosis exhibited reduced airway narrowing following a 3-month period which allowed developmental and weight gains to occur. The patient was a female infant, one month old, with no familial or past history, born at 39 weeks gestation, weighing 2290 g, Apgar score 10/10. There were no respiratory and heart symptoms of note, but a diagnosis of left cleft lip and alveolus was made, and suckling instruction was commenced.
A plan was made to perform cheiloplasty at 7 months and 5960 g post weight-gain. The preoperative chest radiograph was normal, but endo-tracheal intubation to deliver anesthesia was prevented by subglottic resistance. The surgery was postponed due to resultant airway edema post extubation, and concerns over possible subglottic tracheal stenosis. The patient was discharged on following day, and the respiratory status was satisfactory, allowing a growth period, following post radiographic findings of subglottic development. Cheiloplasty was performed at 1 year 3 months old, at weight 7505 g, with intubation, without resistance on induction of anesthesia. At 8 months post-surgery, the respiratory status was normal and the patient was progressing well, with only mild subglottic stenosis. The pre-operative assessment was problematic, however, so a further growth period was allowed to ensure the surgery was successfully performed.
