Endoscopic management of Cotton IV Subglottic Stenosis: How I do it (with video)

The experience with laryngotracheal reconstruction in 20 children in Chicago is reviewed. Nine of the 20 children (45%) operated upon had congenital subglottic stenosis. Ten (50%) had acquired stenosis. One child was classified as having combined types. All patients underwent laryngotracheal reconstruction with autogenous costal cartilage grafts. Eight patients had both anterior and posterior costal cartilage grafts with stent insertion. One had a posterior costal cartilage graft only. Sixteen of the 20 children (80%) have been decannulated. Midtracheal or lower tracheal disease concomitant with laryngotracheal stenosis is an indication that endoscopic management of severe subglottic stenosis is likely to fail. Early laryngotracheal reconstruction is indicated for patients with a high likelihood of failure of endoscopic management and for those with severe cricoid cartilage deformities. Our results support the use of laryngotracheal reconstruction as an alternative to conservative (endoscopic) management of severe subglottic stenosis in carefully selected patients.

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Endoscopic Management of Subglottic Stenosis with the CO2 Surgical Laser

Otolaryngology ◽

10.1177/019459988108900214 ◽

1981 ◽

Vol 89 (2) ◽

pp. 215-220 ◽

Cited By ~ 49

Author(s):

James A. Koufman ◽

James N. Thompson ◽

Robert I. Kohut

Keyword(s):

Carbon Dioxide ◽

Carbon Dioxide Laser ◽

Subglottic Stenosis ◽

Laser Vaporization ◽

Endoscopic Management ◽

New Era ◽

Results Of Treatment ◽

One Year ◽

Surgical Laser

Recent advances in microsurgery of the larynx have heralded a new era in the endoscopic management of subglottic stenosis. The carbon-dioxide laser with bronchoscopic adapters can be successfully employed to reestablish an adequate subglottic lumen. Thirteen cases of subglottic stenosis were managed endoscopically with the carbon dioxide surgical laser. In 77% (10 of 13) of these patients, a satisfactory airway was reestablished within a one-year period. The technique of laser vaporization and the results of treatment are presented. The role of corticosteroid therapy, antibiotic therapy, tracheotomy, dilation, and laryngeal stenting is discussed.

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Endoscopic Management of Idiopathic Subglottic Stenosis

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489416675357 ◽

2016 ◽

Vol 126 (2) ◽

pp. 96-102 ◽

Cited By ~ 11

Author(s):

Sepehr Shabani ◽

Matthew R. Hoffman ◽

William T. Brand ◽

Seth H. Dailey

Keyword(s):

Subglottic Stenosis ◽

Endoscopic Management

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Endoscopic management of subglottic stenosis

Otolaryngology ◽

10.1016/j.otohns.2008.07.024 ◽

2008 ◽

Vol 139 (4) ◽

pp. 551-559 ◽

Cited By ~ 21

Author(s):

Sivi Bakthavachalam ◽

John E. McClay

Keyword(s):

Subglottic Stenosis ◽

Endoscopic Management ◽

Reconstructive Procedure ◽

Success Rates ◽

Successful Result ◽

Number Of Children ◽

Laryngotracheal Reconstruction ◽

Grade Ii ◽

Surgical Modality ◽

Surgical Treatments

Objectives Determine the effectiveness of endoscopic surgical treatment of subglottic stenosis (SGS) in children as a primary surgical modality to prevent laryngotracheal reconstruction (LTR) and as treatment for restenosis following primary LTR to prevent revision LTR. Patients Children undergoing various endoscopic surgical treatments from 1989 to 2006 for SGS. Results The number of children and success rates per grade of SGS and the number of procedures required to produce a successful result in 29 children initially managed endoscopically included grade I, three of three (100%), 1.3 procedures; grade II, eight of nine (88%), 2.6 procedures; and grade III, 13 of 17 (76%), 3.5 procedures. Of 102 patients undergoing open LTR, 56 of 102 required endoscopic interventions and 41 of 56 (73%) children were treated successfully. Conclusion Endoscopic intervention can be used to manage SGS either as a primary intervention or to treat reobstruction and restenosis following an open reconstructive procedure. Success rates decline as the severity of stenosis increases.

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