Pediatria pre prax 4/2020
Laryngotracheal stenosis in children – part II Treatment
Paediatric laryngotracheal stenosis are congenital or acquired narrowing of the airway affecting the larynx and trachea. They represent a wide group of clinical conditions, which treatment is a challenging problem for children‘s otorhinolaryngologists and thoracic surgeons. The primary treatment modality is surgical therapy, where we can distinguish between endoscopic procedures and open surgery. Endoscopic treatment, which applies mainly CO2 laser technology and various dilatations systems with additional topical application of mitomycin-C, corticoid and antibiotic ointment, has only limited use in the management of less severe laryngotracheal stenosis. Open surgery, which includes an expansion laryngotracheal reconstruction and partial cricotracheal resection, is a fundamental stone in the treatment of higher levels chronic laryngotracheal stenosis, which usually require tracheotomy. The success of the treatment is significantly influenced by a correct indication for surgery, optimal timing and performance of a surgical treatment, appropriate postoperative care and rehabilitation. This requires a careful preoperative assessment of the patient and then choosing the most appropriate individual comprehensive management. The article provides an overview of the current knowledge of treatment of laryngotracheal stenosis in children with an emphasis on surgical treatment. The thesis provides information about the various surgical methods focusing on the indications, technique of performance, advantages, disadvantages and results. The last part describes management of patients with laryngotracheal stenosis. The aim of the work is to provide comprehensive information about paediatric laryngotracheal stenosis and introduce the current surgical treatment options in the context of their successful use.
Keywords: paediatric laryngotracheal stenosis, endoscopic treatment, laryngotracheal reconstruction, partial cricotracheal resection, management
