Laryngotracheal Stenosis following Endotracheal Intubation in Children

Abstract

Fifteen cases of laryngotracheal stenosis following endotracheal intubation in infants and children were reported. Eight patients were intubated at birth, 3 patients had anomalies and 5 patients were premature infants with respiratory distress syndrome. These 8 patients received tracheostomies between 1 to 12 months of age. The other seven were intubated between 1 to 9 years in age. They had endotracheal intubation for 7 to 45 days due to miscellaneous maladies such as asthma, cerebral hemorrhage, virus associated hemophagocytotic syndrome as well as other ailments. Six patients had tracheostomies because of severe dyspnea. Although subglottic stenosis was most common in the case of population, but long-term intubated premature infants had other regions of stenosis besides the subglottis.
　The management of tracheostomy is important to maintain an adequate airway and preserve phonatory function while using the smallest tube that will permit adequate ventilation. In 10 patients who had undergone tracheostomies under 2 years of age, 7 patients could speak when plugging the tube with their finger.
　Two patients could decannulate by waiting and one patient by resection of granulated tissue in the area of the tracheostomy. Three of 5 premature infants were treated by external surgical reconstruction using a laryngeal stent, and one patient could be decanulated. Six of 7 patients in the latter group were decanulated by an endoscopic operation using a CO₂ laser and the open stent method (trough method).