Effects of post-intubation laryngeal stenosis treatment depending on the grade of stenosis

Q4 Medicine

New Medicine Pub Date : 2017-06-01 DOI:10.25121/NEWMED.2017.21.3.77

L. Zawadzka-Głos, K. Ślączka

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Abstract

Introduction. Laryngeal stenosis as a complication of prolonged endotracheal intubation is a current problem in paediatric laryngology because of the growing population of prematurely born children. The aim of our study was to analyse the cases of post-intubation laryngeal stenosis in terms of the frequency and severity of the complications, as well as to evaluate the effects of endoscopic treatment. Material and methods. The study included 92 children treated for laryngeal stenosis. The analysis involved the comparison of the children in terms of the degree of subglottic stenosis and its effect on treatment. Laryngeal stenosis was treated with endoscopy, which was performed under general anaesthesia. Results. In the group of children with laryngeal stenosis, supraglottic stenosis was found in 9.78% of children, grade I subglottic stenosis occurred in 10.87% of children, grade II in 41.3% of children, grade III in 18.48% of children, and grade IV in 19.57% of children. Of 92 patients, only 41 were full-term (44.57%) and 51 (55.43%) were premature. In the treated group, full recovery and a reduction of laryngeal stenosis were noted in 44 (48%) and 38 children (41%), respectively, while the failure of treatment was reported in 10 patients, representing 11% of the population. In the group of premature infants, 20 children (39.22%) were cured, the condition improved in 22 cases (43.14%) and treatment failed in 9 patients (17.65%). Of 41 full-term children, full recovery was observed in 24 (58.54%), improvement in 16 (39.02%) and failure in one case (2.44%). There was also an increase in the risk of treatment failure in advanced stenosis of grade III and IV according to Cotton–Myer. Conclusions. Laryngeal stenosis is a common problem in premature infants. Endoscopic treatment is an effective surgical method. Failure of endoscopic treatment is related to the degree of stenosis. Grades III and IV are more difficult to treat. Keywords

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插管后喉狭窄的治疗效果取决于狭窄程度

介绍由于早产儿童的数量不断增加，喉狭窄作为长期气管插管的并发症是儿科喉科目前的一个问题。我们研究的目的是从并发症的频率和严重程度来分析插管后喉狭窄的病例，并评估内镜治疗的效果。材料和方法。该研究包括92名接受喉狭窄治疗的儿童。该分析涉及对儿童声门下狭窄程度及其治疗效果的比较。喉狭窄采用内镜治疗，在全身麻醉下进行。后果在喉狭窄的儿童组中，9.78%的儿童出现声门上狭窄，10.87%的儿童出现I级声门下狭窄，41.3%的儿童出现II级，18.48%的儿童发现III级，19.57%的儿童发现IV级。在92名患者中，只有41名是足月患者（44.57%），51名是早产患者（55.43%）。在治疗组中，44名儿童（48%）和38名儿童（41%）分别完全康复和喉狭窄减少，而10名患者（占总人数的11%）报告治疗失败。早产儿组治愈20例（39.22%），病情好转22例（43.14%），治疗失败9例（17.65%），改善16例（39.02%），失败1例（2.44%）。根据Cotton-Myer的数据，III级和IV级晚期狭窄的治疗失败风险也有所增加。结论。喉狭窄是早产儿常见的问题。内窥镜治疗是一种有效的手术方法。内镜治疗的失败与狭窄程度有关。III级和IV级更难治疗。关键词

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来源期刊

New Medicine Medicine-General Medicine

CiteScore

0.10

自引率

0.00%

发文量

审稿时长

12 weeks

期刊介绍： - New Medicine is indexed in Index Copernicus (IC value 6.60) and registered in Embase/Excerpta Medica. - It is published in English and some issues in other languages. - New Medicine covers a broad spectrum of disciplines. - New Medicine is sent to national and medical libraries in several countries all over the world and to some libraries and institutions in Poland. It is also present on medical conferences. - New Medicine is published under the patronage of Polish Society of Health Education.