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Int Arch Otorhinolaryngol 2012; 16(02): 217-221
DOI: 10.7162/S1809-97772012000200010
Original Article
Thieme Publicações Ltda Rio de Janeiro, Brazil

Single-stage laryngotracheal reconstruction for the treatment of subglottic stenosis in children

Reconstrução laringotraqueal em único estágio para tratamento de estenose subglótica em crianças
Mariana Magnus Smith
1   Master. Medical Residency Preceptor of Otolaryngology of Hospital São Lucas of PUCRS / Sao Lucas Hospital of PUC/RS - Catholic University, Rio Grande do Sul State, Brazil.
,
Cláudia Schweiger
2   Master. Medical Residency Preceptor of Otolaryngology of Hospital de Clínicas of Porto Alegre/Clinical Hospital of Porto Alegre, Rio Grande do Sul State, Brazil.
,
Denise Manica
3   Otolaryngologist. Fellowship in Laryngology of Hospital de Clínicas of Porto Alegre/ Clinical Hospital of Porto Alegre, Rio Grande do Sul State, Brazil.
,
Camila Degen Meotti
4   Otolaryngologist. Fellowship em Rhinology of Hospital de Clínicas of Porto Alegre/ Clinical Hospital of Porto Alegre, Rio Grande do Sul State, Brazil.
,
Larissa Valency Eneas
5   Otolaryngologist. Medical Residency Preceptor of Otolaryngology of Hospital São Lucas of PUCRS/ Sao Lucas Hospital of PUC/RS - Catholic University, Rio Grande Do Sul State, Brazil.
,
Gabriel Kuhl
6   Otolaryngologist. Professor of Otolaryngology and Ophthalmology Department of UFRGS. Medical Residency Preceptor of Otolaryngology of HCPA- Clinical Hospital of Porto Alegre.
,
Paulo Jose Cauduro Marostica
7   Post-Ph.D. Professor of Pediatrics Department of UFRGS - Federal University of Rio Grande do Sul State. Medical Residency Preceptor of Pediatrics of HCPA - Clinical Hospital of Porto Alegre.
› Author Affiliations
Further Information

Publication History

07 September 2011

12 October 2011

Publication Date:
05 December 2013 (online)

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Summary

Introduction: In recent decades, airway reconstruction has become the treatment of choice for subglottic stenosis (SGS) in children, which is performed in either single or multiple stages. However, there is evidence in the literature that single-stage surgery is more effective.

Objective: To evaluate the success rate of single-stage laryngotracheoplasty (LTP) and cricotracheal resection (CTR) in patients that were treated in our hospital.

Materials and Method: We performed a retrospective study of children undergoing laryngotracheal reconstruction.

Results: Twenty-four children were included. The etiology of SGS was postintubation in 91.6% and congenital in 8.3%. One patient (4.2%) had grade 4 SGS, 17 (70.8%) presented with grade 3 SGS, 4 (16.6%) had grade 2 SGS, 1 (4.2%) had grade 3 SGS associated with glottic stenosis, and 1 (4.2%) had grade 3 SGS with tracheal stenosis. We performed 26 LTPs and 3 CTRs. Decannulation rates were 66% in the CTR procedures and 85.7% in the LTP procedures; the overall decannulation rate was 83.3%. All children presented with fever in the postoperative period, but were afebrile after the tube was removed.

Conclusion: Our series showed a decannulation rate of 83.3%.

Resumo

Introdução: Nas últimas décadas, a reconstrução da via aérea tornou-se o tratamento de escolha para estenose subglótica (ESG) na criança, realizada em único ou múltiplos estágios. Há indícios na literatura de que a cirurgia em um só tempo é mais efetiva.

Objetivo: Avaliar o índice de sucesso da laringotraqueoplastia (LTP) e ressecção cricotraqueal (RCT) em único estágio nos pacientes tratados no nosso hospital.

Método: Estudo retrospectivo de crianças submetidas à reconstrução laringotraqueal.

Resultados: Foram incluídos 24 pacientes. As causas da ESG foram pós-intubação endotraqueal em 91,6% e congênita em 8,3%. Diagnosticamos ESG grau 4 em 1 paciente (4%), grau 3 em 16 (66,6%), grau 2 em 4 (16,6%), grau 3 associada com estenose glótica em 1 (4%), grau 3 associada com estenose traqueal em 1 (4%). Foram realizadas 26 LTP e 3 RCT. O índice de decanulação foi de 66% nos pacientes submetidos à RCT e de 85,7% nos pacientes submetidos à LTP; o índice total de decanulação foi de 83,3%. Todos apresentaram febre persistente no pós-operatório, que cessou após a extubação.

Conclusão: Nossa série mostrou índice de decanulação de 83,3%.

Keywords

larynx - child - laryngostenosis

Palavras-Chave

laringe - criança - laringoestenose
 

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