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Pediatr Surg Int. 2013 Oct;29(10):1001-6. doi: 10.1007/s00383-013-3397-2.

Management of laryngotracheal stenosis in infants and children: the role of re-do surgery in cases of severe subglottic stenosis.

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  • 1Division of Pediatric Surgery, Department of Surgery, Jichi Medical University School of Medicine, 3311-1, Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan, maedak@jichi.ac.jp.

Abstract

Although many advances have improved the treatment of congenital and acquired laryngotracheal stenosis in children over the past two decades, the therapeutic decision-making process remains challenging for pediatric surgeons and otolaryngologists. Severe subglottic stenosis is a complex laryngeal injury that necessitates multiple airway procedures, and the approach depends on the exact nature of the cicatricial lesion and its effect on the vocal cord mobility. Therefore, it is imperative that the pediatric surgeons and otolaryngologists dealing with this situation should be well trained in endoscopy and laser treatment, in addition to open surgical intervention. Open re-do surgery remains the best choice in cases of severe congenital stenosis, glottic immobility, or after two to three endoscopic procedures have been performed without any significant improvement.

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