Management specificities of congenital laryngeal stenosis: external and endoscopic approaches.

Abstract

OBJECTIVES/HYPOTHESIS:

This study aimed to report our experience in the management of congenital laryngeal stenosis and to compare our series and results to published data in the literature.

STUDY DESIGN:

Retrospective case series. Tertiary referral center for rare pediatric head and neck malformations.

METHODS:

Medical charts of patients diagnosed with congenital laryngeal stenosis in our institution were reviewed over a 15-year period, from 1996 to 2011. Surgical treatment consisted of an endoscopic procedure, open laryngeal surgery (OLS), or a combination of both.

RESULTS:

Sixteen patients met the inclusion criteria for the study and were divided in two groups: the endoscopic laryngoplasty (EL) group, with patients who underwent the endoscopic procedure as first-line treatment, and the OLS group, whose patients underwent open laryngoplasty with cartilage graft as first-line treatment. Each group contained eight patients with grade II to IV congenital stenosis. All patients, except one in the EL group, achieved a good result (<50% residual stenosis) at the end of the follow-up.

CONCLUSIONS:

This case series suggests that EL, with incision of the subglottic laryngeal cartilages with cold steel instruments and balloon dilation, is a safe and effective treatment for congenital laryngeal stenosis grade II to IV. This procedure could be considered as an alternative option to OLS, even as a first-line procedure. An endoscopic procedure does not preclude the possibility for an open laryngeal procedure in case of failure. A prolonged follow-up is mandatory.

LEVEL OF EVIDENCE:

4.

• Authors: Marion Blanchard, Nicolas Leboulanger, Briac Thierry, Jean-Philippe Blancal, Fergal Glynn, Françoise Denoyelle, Erea Noël Garabedian
• Journal: The Laryngoscope (Laryngoscope) Vol. 124 Issue 4 Pg. 1013-8 (Apr 2014) ISSN: 1531-4995 [Electronic] United States
• PMID: 24105758 (Publication Type: Journal Article)
• Copyright: © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Topics

• Child, Preschool
• Female
• Follow-Up Studies
• Humans
• Infant
• Infant, Newborn
• Laryngoplasty (methods)
• Laryngoscopy (methods)
• Laryngostenosis (congenital, diagnosis, therapy)
• Larynx (abnormalities, surgery)
• Male
• Retrospective Studies
• Treatment Outcome