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Acquired Laryngotracheal Disease
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
Some children are prone to recurrent episodes of ‘croup’ and may be referred to the ORL service for investigation to rule out an underlying cause. Very occasionally, cases of undiagnosed laryngotracheal stenosis present in this way and endoscopy can be reassuring, but more often there is no structural abnormality and the symptoms are due to mucosal hypersensitivity. Often, these children go on to develop bronchial asthma and continued monitoring and surveillance under the supervision of a paediatrician may be needed.
Dermatological emergencies in tropical infections and infestations
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Anup Kumar Tiwary, Niharika Ranjan Lal, Piyush Kumar
In rhinoscleroma, granulomatous lesions start healing with dense fibrosis leading to stenosis and/or deformity of the involved structures such as Hebra nose (due to nasal cartilage destruction). Laryngotracheal stenosis may be life threatening, necessitating emergency tracheostomy.
Contemporary Management of Laryngotracheal Trauma
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Carsten E. Palme, Malcolm A. Buchanan, Shruti Jyothi, Faruque Riffat, Ralph W. Gilbert, Patrick Gullane
Endoscopic management of laryngotracheal stenosis is thought to be appropriate for patients whose injury does not involve the cartilage. Balloon dilatation can be used initially, but since the introduction of carbon dioxide (CO-2) lasers, a variety of endoscopic management techniques have evolved.60 These include the neodynium-doped yttrium aluminium garnet (Nd:YAG) and microscope-mounted CO2 laser.61 Recently, CO2 ablation via awake flexible bronchoscopy has been described.62, 63
Supraglottic stenosis in a case of Behcet’s disease
Published in Scandinavian Journal of Rheumatology, 2018
M Hajialilo, M Nasemieh, A Khabbazi
Behcet’s disease (BD) is an inflammatory systemic disease characterized by recurrent oral aphthous ulcers (OAUs), genital aphthous ulcers, cutaneous lesions, and uveitis. OAUs occur mainly in the oral cavity (1). Aphthous ulceration is rarely reported in other parts of the aerodigestive tract, such as the hypopharynx, larynx, and vocal cords (2). Aphthous ulcerations in the aerodigestive tract almost always heal without scarring but, in very rare cases, large ulcers produce scars. Supraglottic stenosis is a rare subset of laryngotracheal stenosis. In a large retrospective study, 3% of patients with laryngotracheal stenosis had supraglottic stenosis (3). Symptoms of supraglottic stenosis in adults include dysphagia, inspiratory stridor, resting and exertional dyspnoea, and changes in the voice (4). Stevens et al, in a case series study on eight patients, reported that the most common cause of laryngotracheal stenosis (62.5%) is radiation injury (4). The remainder of their patients had autoimmune disease (37.5%). In 1951, Kenet reported the first case of laryngeal involvement in BD, which was resistant to treatment with steroids and needed repeated tracheotomies (5). Since then, only a few cases of laryngeal stenosis in BD have been described. Table 1 shows the published cases of laryngeal involvement in BD. In this article, we report a case of BD with supraglottic laryngeal stenosis.
Update on the diagnosis and management of pediatric laryngotracheal stenosis
Published in Expert Review of Respiratory Medicine, 2022
Matthew M Smith, Lauren S Buck
Laryngotracheal stenosis can be subdivided into laryngeal stenosis and tracheal stenosis as well as congenital and acquired etiologies. Congenital etiologies of laryngeal stenosis include laryngeal atresia, laryngeal webs, and laryngeal clefts. These etiologies usually cause respiratory symptoms within the first year of life. Causes of tracheal stenosis, such as complete or absent tracheal rings, can be difficult to diagnose. Acquired laryngotracheal stenosis, while previously was primarily related to traumatic injuries and infectious processes, is now mostly in part to scar tissue due to prolonged intubation [1]. The pediatric subglottis is especially susceptible to injury as this is the narrowest portion of the pediatric airway.
Novel tubeless supraglottic ventilation in a difficult paediatric airway
Published in Egyptian Journal of Anaesthesia, 2018
Ng Ruth, Budiman Maryam, Azman Mawaddah, Goh Bee-See
Issues concerning ventilation and oxygenation for surgery for laryngotracheal stenosis are always challenging. Conventional methods of endotracheal intubation may not be ideal due to obstructed surgical field and some procedures such as dilatation requires unrestricted access to the larynx. Therefore, various tubeless methods have been reported throughout the years. These methods involve either tubeless spontaneous respiration technique or tubeless jet ventilation.