Clinic, diagnosis and treatment of tracheal stenosis

• Published in: Anales de pediatría (Barcelona, Spain : 2003) Spain : 2003), 2009-05, Vol.70 (5), p.443-448
• Main Authors: Delgado Pecellín, I, González Valencia, J P, Machuca Contreras, M, Pineda Mantecón, M
• Format: Article
• Language: Spanish
• Subjects: Child, Preschool; Female; Humans; Infant; Male; Retrospective Studies; Tracheal Stenosis - diagnosis; Tracheal Stenosis - surgery
• ISSN: 1695-4033
• DOI: 10.1016/j.anpedi.2008.12.014

New surgical techniques have been developed for treatment of tracheal stenosis (TS) over the last few years. The aim of the present study is to examine the clinical, therapeutic characteristics and progress of the cases of TS diagnosed in our hospital from January 2004 to August 2007. We have reviewed the clinical history, focusing on age at diagnosis, clinical signs and symptoms, baseline pathology, previous history of mechanical ventilation, degree of stenosis, diagnostic technique, treatment and progress. A total of 16 cases were found, (2 congenital and 14 acquired). Mean age at diagnosis was 8.8 months (23 days-2.5 years). Of these, 14 patients had been intubated (3-44 days). Clinical suspicion was prompted by inspiratory stridor (44%), difficulty to be extubated or intubated (28%) and recurrent laryngotracheitis (39%). Three patients received CO(2) laser therapy and suffered a high number of restenosis and required re-interventions. Three patients underwent costal cartilage tracheoplasty and tracheal-cricoid split, showing a good prognosis and one patient underwent a slide tracheoplasty. Five patients with only a few clinical signs and mild stenosis, were managed on a wait and see basis. One patient with tracheal membrane underwent resection of the stenosed portion and end-to-end anastomosis with favourable progress. Another patient had a partial cricotracheal resection but suffered three restenoses. Two patients underwent surgical correction of the vascular ring. Asymptomatic patients may receive conservative therapy. In the case of short-segment stenosis, resection and end-to-end anastomosis is the therapy of choice and the long-segment stenosis has obtained good results by means of slide tracheoplasty, which involved no deaths and a very low morbidity.