ABSTRACT
Over a 10 year period from 1984 to 1994, 98 children underwent curative treatment for sub-glottal stenosis of the larynx at La Timone Hospital in Marseille, France. Eighty-two patients were operated on via an external approach. An endoscopic procedure with the CO2 laser was used in 16 cases. The majority of the children had acquired stenosis (77%), with greater than 70% obstruction (65%), and were under 5 years of age (60%). The details of the different therapeutic techniques used are presented. The laryngotracheoplasty technique used to widen the larynx (n = 58) with an autologous rib cartilage (n = 53) is the most important current progress. The possibilities for laryngotracheofissure (n = 21) and cricotracheal resection (n = 3) are also discussed. After decannulation, 95% of the children could breath normally via the natural airways. The quality of the outcome was not dependent on the therapeutic method used. Perspectives for new methods or modifications of existing methods are discussed.
Subject(s)
Endoscopy , Laryngostenosis/surgery , Laser Therapy , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Intubation, Intratracheal/adverse effects , Laryngostenosis/etiology , Larynx/surgery , Male , Retrospective Studies , Trachea/surgery , Treatment OutcomeABSTRACT
The authors report about their experience with partial lower turbinectomy. Twenty-nine cases were followed up over an average time lapse of 2 years. Anterior rhinomanometry was performed pre- and postoperatively in all patients. The results include 26 successful operations (90%) and 3 failures, one case of hemorrhage on pack removal and one of synechia. In view of the 3 failures, the authors are presently favorable to subtotal lower turbinectomy.
Subject(s)
Endoscopy/methods , Turbinates/surgery , Adolescent , Adult , Female , Follow-Up Studies , Humans , Male , Manometry , Middle Aged , Nasal Obstruction/surgery , Rhinitis, Vasomotor/surgeryABSTRACT
Since laryngotracheofissiure, or anterior cricotomy, has been introduced in 1980, the number of tracheotomies performed in infants has decreased as this procedure is an alternative to tracheotomy for difficult extubation. Since then, the indications of this procedure have become wider, but a number of preoperative criteria, such as the pulmonary capacity, must be strictly assessed. We report on our experience with 14 children who underwent laryngotracheofissiure during the past 4 years. The indications, the surgical technique and the results are evaluated.
Subject(s)
Cricoid Cartilage/surgery , Intubation, Intratracheal/adverse effects , Laryngostenosis/etiology , Female , Glottis , Humans , Infant , Infant, Newborn , Laryngeal Cartilages/surgery , Laryngostenosis/congenital , Laryngostenosis/surgery , Male , Retrospective Studies , TracheotomyABSTRACT
Subglottic laryngeal cysts in the newborn are extremely rare. It is difficult to establish if the cyst is acquired or congenital because respiratory distress requires intubation in the I.C.U. generally without prior endoscopy. A case report is presented, followed by a discussion of possible aetiology and management protocol; the advantages of the CO2 laser make excision of the cystic sac possible without tracheotomy.
