Treatment of Severe Subglottic Stenosis without Tracheotomy

1982 ◽  
Vol 91 (4) ◽  
pp. 407-412 ◽  
Author(s):  
Lauren D. Holinger
Keyword(s):  
Surgical Technique ◽  
General Anesthesia ◽  
Subglottic Stenosis ◽  
Infants And Children ◽  
Endoscopic Procedures ◽  
Laryngeal Trauma ◽  
Endoscopic Excision ◽  
Laryngotracheal Reconstruction

Subglottic stenosis in neonates, infants and children is one of the most challenging problems confronting the pediatric otolaryngologist today. Small patients with congenital or acquired stenosis severe enough to require tracheotomy must undergo repeated endoscopic procedures or laryngotracheal reconstruction; weeks, months, or years may be required to attain a lumen large enough to permit decannulation. During 1981, six infants and children with severe subglottic stenosis were managed without tracheotomy. The surgical technique employed involves endoscopic excision of the offending subglottic tissue using the CO2 laser and suspension microlaryngoscopy. Intraoperative intubation is avoided by using an insufflation technique for general anesthesia which permits unobstructed visualization of the larynx, thereby avoiding laryngeal trauma and edema.

scholarly journals Utility of Two-Stage Laryngotracheal Reconstruction in the Management of Subglottic Stenosis in Adults

2009 ◽  
Vol 119 (S3) ◽  
pp. S263-S263
Author(s):  
Nathan A. Deckard ◽  
Justin Yeh ◽  
Michael Criddle ◽  
Robert Stachler ◽  
James Coticchia
Keyword(s):  
Subglottic Stenosis ◽  
Two Stage ◽  
Laryngotracheal Reconstruction

Laryngotracheal Reconstruction Using Microplates in a Porcine Model With Subglottic Stenosis

1996 ◽  
Vol 106 (3) ◽  
pp. 301-305 ◽  
Author(s):  
Mary T. Mitskavich ◽  
Frank L. Rimell ◽  
Andrew M. Shapiro ◽  
J. Christopher Post ◽  
Silloo B. Kapadia
Keyword(s):  
Porcine Model ◽  
Subglottic Stenosis ◽  
Laryngotracheal Reconstruction

Development of a high fidelity subglottic stenosis simulator for laryngotracheal reconstruction rehearsal using 3D printing

2019 ◽  
Vol 124 ◽  
pp. 134-138 ◽  
Author(s):  
Chelsea L. Reighard ◽  
Kevin Green ◽  
Allison R. Powell ◽  
Deborah M. Rooney ◽  
David A. Zopf
Keyword(s):  
3D Printing ◽  
Subglottic Stenosis ◽  
High Fidelity ◽  
Laryngotracheal Reconstruction

Anesthesia for Gastrointestinal Endoscopic Procedures

2018 ◽  
Author(s):  
Lori Kral Barton ◽  
Regina Y. Fragneto
Keyword(s):  
General Anesthesia ◽  
Patient Characteristics ◽  
The United States ◽  
Anesthetic Techniques ◽  
Anesthesia Care ◽  
Care Providers ◽  
Endoscopic Procedures ◽  
Endoscopic Techniques ◽  
Sole Agent ◽  
Geographic Regions

As the population ages, patients presenting for endoscopic procedures are more likely to have significant comorbidities. In addition, endoscopic procedures of increasing complexity are being performed. While there are significant differences among geographic regions in the United States, anesthesia care providers are providing sedation or general anesthesia for a greater proportion of procedures performed in the endoscopy suite. A variety of drugs and anesthetic techniques have been used successfully. Propofol remains the most commonly used drug when sedation is provided by an anesthesia professional, sometimes as a sole agent and sometimes in combination with other medications. Dexmedetomine and ketamine have also been used successfully. Patient characteristics and the specific needs of the endoscopist based on the procedure being performed will determine the most appropriate anesthetic regimen for each patient. For more complex endoscopic techniques, general anesthesia may be preferred, with some data indicating improved success of the procedure.

Effect of stenting after laryngotracheal reconstruction in a subglottic stenosis model☆☆☆

2000 ◽  
Vol 122 (4) ◽  
pp. 488-494 ◽  
Author(s):  
BRIAN S. JEWETT ◽  
RAYMOND D. COOK ◽  
KENNETH L. JOHNSON ◽  
THOMAS C. LOGAN ◽  
WILLIAM W. SHOCKLEY
Keyword(s):  
Subglottic Stenosis ◽  
Laryngotracheal Reconstruction

Prolonged Intubation Injuries of the Larynx: Endoscopic Diagnosis, Classification, And Treatment

2018 ◽  
Vol 127 (8) ◽  
pp. 492-507 ◽  
Author(s):  
Bruce Benjamin
Keyword(s):  
General Anesthesia ◽  
Endotracheal Intubation ◽  
Granulation Tissue ◽  
Direct Laryngoscopy ◽  
Prolonged Intubation ◽  
Laryngeal Trauma ◽  
Flow Charts ◽  
Diagnosis Classification ◽  
Classification And Treatment

Laryngeal trauma from prolonged endotracheal intubation occurs in patients of all ages. Most changes are superficial and heal quickly. Injuries that are found consistently during intubation include nonspecific changes, edema, granulation tissue, ulceration, and othermiscellaneous injuries. In thispapersignificant, severe, and lasting trauma of the larynx has been classified on thebasis of theknown factors in pathogenesis, observations made atendoscopy, and photographic documentation. This classification has required introduction of new descriptive terminology: “tongues of granulation tissue,” “ulcerated troughs,” “healed furrows,” and “healed fibrous nodule.” During intubation the degree of injury can be precisely assessed under general anesthesia by using telescopes for image magnification, thus assisting adecision whether to continue intubation orperform tracheotomy to minimize long-term morbidity. Changes that are found after extubation result from granulation tissue, ulceration, ora combination of both and have been illustrated on flow charts; a knowledge and understanding of these sequelae allows them to be identified by both indirect and direct laryngoscopy so that treatment can be planned.

Acquired subglottic stenosis: aetiological profile and treatment results

2014 ◽  
Vol 128 (7) ◽  
pp. 641-648 ◽  
Author(s):  
S Pookamala ◽  
A Thakar ◽  
K Puri ◽  
P Singh ◽  
R Kumar ◽  
...  
Keyword(s):  
Vocal Fold ◽  
Subglottic Stenosis ◽  
Surgical Results ◽  
Cartilage Graft ◽  
Treatment Results ◽  
Endoscopic Procedures ◽  
Surgical Options ◽  
Vocal Fold Immobility ◽  
External Injury ◽  
And Cartilage

AbstractObjectives:To analyse the aetiological profile and surgical results of patients with acquired chronic subglottic stenosis, and formulate a surgical scheme based on an audit of various surgical procedures.Methods:Thirty patients were treated by 65 procedures (31 endoscopic and 34 external) between 2004 and 2009.Results:Isolated subglottic stenosis was noted as unusual in the majority (27 cases), demonstrating contiguous tracheal or glottic involvement. The major aetiologies were intubation injury (n = 8) and external injury (n = 21) (i.e. blunt trauma, strangulation or penetrating injury). Vocal fold immobility and cartilage framework involvement were frequent with external injury and infrequent with intubation injury. Luminal restoration was achieved by endoscopic procedures in 2 cases, external procedures in 19 cases, and external plus adjuvant endoscopic procedures in 8 cases. The preferred surgical options were: endoscopic procedures, restricted to short, recent, grade I or II mucosal stenosis cases; and external procedures for all other stenosis situations, including isolated subglottic (anterior cricoid split plus cartilage graft), subglottic and glottic or high subglottic (anterior plus posterior cricoid split with cartilage graft), and subglottic and tracheal (cricotracheal resection with anastomosis).Conclusions:External injury stenosis has a worse profile than intubation injury stenosis. Anatomical categorisation of subglottic stenosis guides surgical procedure selection. Endoscopic procedures have limited indications as primary procedures but are useful adjunctive procedures.

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