Document Detail


Long-term outcome of surgically treated acquired subglottic stenosis in infancy.
MedLine Citation:
PMID:  10922134     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There is little information about the long-term outcome of infants with acquired severe subglottic stenosis (SGS) who require surgical intervention. We retrospectively identified infants with acquired subglottic stenosis who required anterior cricoid split (ACS) or tracheostomy for primary airway management; some of these children later required laryngotracheoplasty (LTP). All children were treated at our hospital from 1989-1997. During follow-up, we assessed patients for persistent symptoms (stridor at rest, exercise limitation, difficulty with respiratory tract infections, recurrent croup, and voice alteration), and we measured lung function when possible. We identified 34 infants with acquired SGS: 13 treated primarily with tracheostomy, and 21 with ACS. Nine patients could not be extubated following ACS and required tracheostomy, while the 12 who were extubated were followed up at a mean time of 76 months postoperatively; 3 had moderate stridor at rest, 1 moderate exercise limitation, and none had recurrent croup. Four of 5 who had lung function measured had moderately severe extrathoracic airflow limitation. From the tracheostomy group (n = 13) and the failed ACS group (n = 9), 2 patients were decannulated without further surgery, 17 underwent LTP, and 2 have LTP planned. Fifteen of the 17 patients who had LTP have been decannulated. Follow-up, at a mean time of 58 months postoperatively, showed none with stridor at rest, 3 with moderate exercise limitation, none with recurrent croup, and 2 with moderate voice alteration. All 5 patients who had lung function measured had airflow limitation, 1 being severe. In conclusion, ACS facilitates extubation in selected patients with severe, acquired SGS of infancy, and the long-term outcome of patients successfully extubated is excellent. Failure of ACS invariably means tracheostomy, and subglottic repair by LTP is associated with a good long-term outcome.
Authors:
R J Massie; C F Robertson; R G Berkowitz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric pulmonology     Volume:  30     ISSN:  8755-6863     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-09-25     Completed Date:  2000-09-25     Revised Date:  2006-03-28    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  125-30     Citation Subset:  IM    
Copyright Information:
Copyright 2000 Wiley-Liss, Inc. 2000
Affiliation:
Department of Respiratory Medicine, Royal Children's Hospital, Parkville, Australia. massiej@cryptic.rch.unimelb.edu.au
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MeSH Terms
Descriptor/Qualifier:
Airway Obstruction / pathology,  surgery
Cricoid Cartilage / pathology,  surgery*
Croup
Female
Glottis / pathology*,  surgery
Humans
Infant
Infant, Newborn
Laryngostenosis / pathology,  surgery
Male
Recurrence
Retrospective Studies
Tracheal Stenosis / pathology,  surgery*
Tracheostomy*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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