Management considerations in congenital laryngotracheal stenosis

Congenital laryngotracheal stenosis poses significant management challenges, necessitating multidisciplinary input involving paediatric intensivists, neonatologists and paediatric otolaryngologists. Management decisions and patient outcomes are often compounded by coexisting factors including extreme prematurity, gestational age at time of diagnosis and low birth weight. The pathophysiology, treatment options and management considerations related to this complex pathology are discussed.

Isobel Rothera
MBBS, BSc, MRCS
Core Surgical trainee, Guys and St Thomas’ NHS Trust
isobel.rothera@nhs.net

Mira Sadadcharam
FRCS (ORL-HNS), PhD
Consultant Paediatric ENT Surgeon,
Royal Manchester Children’s Hospital

Archana Mishra
MBBS, MD, MRCPCH
Consultant Neonatologist, Bolton NHS
Foundation Trust

Richard J Hewitt
BSc, DOHNS, FRCS (ORL-HNS)
Consultant Paediatric ENT, Head and Neck and Tracheal Surgeon, Great Ormond Street Hospital for Children

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Keywords

tracheal stenosis; congenital airway anomalies; bronchoscopy; tracheal surgery; laryngeal surgery; extreme prematurity

Also published in Infant:

VOLUME 17/ISSUE 5, SEPTEMBER 2021

Problems and perceptions around severe bronchopulmonary dysplasia

Advances in neonatal care have led to increased survival of the extreme preterm infant, yet bronchopulmonary dysplasia (BPD) as a comorbidity has shown an increasing trend. A major proportion of preterm infants who remain invasively ventilated at term-corrected gestational age go on to require long-term respiratory support yet the management and prognosis for severe BPD shows wide regional variation depending on availability of resources. This article addresses conundrums regarding the management of severe BPD and the care pathway, including a survey of practice to give a UK regional perspective.