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 18 ISSUE 2/MARCH 2022

LCHAD deficiency and extreme prematurity: challenging aspects of nutritional management

In this article we present the case of an extremely preterm female infant who was born at 22⁺⁵ weeks’ gestation following an antepartum haemorrhage. A postnatal genetic diagnosis of long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) deficiency was made. LCHAD deficiency is a complex metabolic condition, which can be even more challenging to treat when combined with extreme prematurity. Using specialised milk formulas in an extremely preterm infant was a difficult decision; this case report aims to highlight such nutritional and metabolic challenges.