Update on the diagnosis and management of pediatric laryngotracheal stenosis

Expert Rev Respir Med. 2022 Oct;16(10):1035-1041. doi: 10.1080/17476348.2022.2145947. Epub 2022 Nov 18.

Abstract

Introduction: Laryngotracheal stenosis comprises a broad spectrum of congenital and acquired conditions that commonly cause pediatric airway obstruction. With the introduction and popularization of operative procedures such as laryngotracheoplasty, cricotracheal resection, and slide tracheoplasty more patients are presenting with airway issues at multiple anatomic levels. A combination of endoscopic and open techniques continues to be utilized for these complex issues. Additionally, there are specific long-term considerations for the post reconstruction patient.

Areas covered: This review highlights important aspects of the diagnosis, work up, and surgical treatment of pediatric laryngotracheal stenosis with updates for revision airway surgery and the post reconstruction patient. Important research articles and techniques within pediatric airway reconstruction are summarized and included in the review, in addition to recent articles from the last five years on pediatric laryngotracheal stenosis which were identified through a search of the PubMed database.

Expert opinion: The multidisciplinary concept of evaluation and treatment of laryngotracheal stenosis continues to be essential. Revision airway surgery presents unique challenges to improve the quality of life of patients as they age after reconstruction. Tracheal transplantation remains an important research area in the treatment of laryngotracheal stenosis.

Keywords: Subglottic stenosis; balloon dilation; cricotracheal resection; laryngotracheoplasty; pediatric airway reconstruction; revision airway surgery; slide tracheoplasty; tracheal stenosis.

Publication types

  • Review

MeSH terms

  • Child
  • Constriction, Pathologic
  • Humans
  • Laryngostenosis* / diagnosis
  • Laryngostenosis* / surgery
  • Quality of Life
  • Retrospective Studies
  • Tracheal Stenosis* / diagnosis
  • Tracheal Stenosis* / etiology
  • Tracheal Stenosis* / surgery
  • Treatment Outcome