Conservative Management in Congenital Tracheal Stenosis: Clinical Course After Long-Term Follow-Up

Abstract

Purpose: Children with severe congenital tracheal stenosis (CTS) require tracheal reconstruction. However, the indication of conservative management for patients with mild symptoms is unclear. The aim of this study was to review the nonoperatively managed CTS cases and determine the characteristics of these cases.

Methods: A retrospective study was carried out on 11 CTS patients managed nonoperatively in our institute between 2000 and 2009. Patients with severe upper airway disorders were excluded. All patients were observed for a minimum of 4 years. The following data from the records of their computed tomography scans, outcome and follow-up period were studied: sex, age at onset, anatomical type, lumen diameter of the most stenotic part of the trachea and its ratio to normal tracheal lumen diameter (stenosis rate).

Results: Six girls and 5 boys were included. The age at onset was in the range from 0 to 15 months. Two patients were asymptomatic, 5 patients showed occasional symptoms, and 4 patients showed persistent respiratory symptoms. The observation periods ranged from 58 to 185 months, and the symptoms improved along with growth. Three patients needed temporary ventilation. The mean lumen diameter of the most stenotic part of the trachea was 2.8 mm, and serial CT scans of 6 patients showed the growth of the stenotic parts. Mean stenosis rate was 46% at diagnosis and showed no significant change during the follow-up period.

Conclusions: Conservative management is warranted for patients with minimal symptoms; however, it is a challenging strategy and careful observation is required in treating abrupt respiratory distress.