A new method of treatment for complete tracheal rings in an infant: Endoscopic laser division and balloon dilation☆
Section snippets
Case report
A 5-week-old girl with the stigmata of Down's Syndrome, had a patent ductus arteriosus, a patent foramen ovale, and a large abdominopelvic mass. Plans were made to excise the mass, but at operation, an endotracheal tube could not be passed into the trachea. The patient had tight tracheal stenosis, and she was referred for therapy. Endoscopy findings showed a narrowing of the trachea just at the thoracic inlet, 2.5 cm below the vocal cords. The lumen measured only 1.0 mm in diameter (Fig 1), and
Discussion
Infants born with complete tracheal rings often have respiratory distress, but sometimes the airway compromise is manifest later. There have been many techniques described for the treatment of complete tracheal rings in an infant: (1) Resection and primary anastomosis1, 2; (2) anterior incision of the stricture with the insertion of cartilage,3 pericardium,4, 5 or periosteum6 (cartilage insertion results in a complete ring, although larger, and pericardium or periosteum often produce
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Cited by (36)
Diagnosis and Management of Tracheal Anomalies and Tracheal Stenosis
2021, Cummings Pediatric OtolaryngologyPediatric Interventional Pulmonology
2018, Clinics in Chest MedicineCitation Excerpt :Other potential indications include tracheal pouches and cysts,67 recurrent tracheoesophageal fistula,68,69 airway angiomas,70–72 tracheal papillomatosis (Fig. 9),57,59,73,74 endobronchial tuberculosis,36,56 and various types of tumors.75–80 Cartilage resection is also possible and has been described in CTS37,38,81 and tracheostomy-induced cartilage prolapse.57,65 Before operating a laser in the pediatric airways, the operator should familiarize himself or herself with the patient’s vascular anatomy surrounding the airways to avoid complications in case of vascular and mediastinal malformations.
Surgical Disorders of the Chest and Airways
2018, Avery's Diseases of the Newborn: Tenth EditionSurgical Disorders of the Chest and Airways
2017, Avery's Diseases of the Newborn, Tenth EditionPediatric Tracheal Anomalies
2014, Cummings Pediatric OtolaryngologyPrimary dilatation as a treatment for pediatric laryngotracheal stenosis: A systematic review
2013, International Journal of Pediatric OtorhinolaryngologyCitation Excerpt :There were insufficient patients to make clear comparisons between proximal and distal tracheal LTS, or between short and long segment tracheal LTS. The etiology of LTS could be determined in 21 studies (n = 144) [9–26,28–30]. The majority was acquired (n = 126, 88%) and a minority was congenital LTS (n = 18, 13%).
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Address reprint requests to H. Biemann Othersen, Jr, MD, Medical University of South Carolina, 171 Ashley Ave, 300 MUSC Complex, Suite 205, Charleston, SC 29425.