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March 1997

Supraglottic Stenosis in Infants and ChildrenA Preliminary Report

Arch Otolaryngol Head Neck Surg. 1997;123(3):337-341. doi:10.1001/archotol.1997.01900030123015

Objectives:  To describe a condition identified in the pediatric population that narrows the supraglottic larynx. This condition has been termed supraglottic stenosis/collapse. To discuss common factors present in these children and to examine potential causes of this specific condition.

Design:  Retrospective review of patients with supraglottic stenosis/collapse from October 1985 to June 1993.

Setting:  Academic tertiary care children's hospital.

Patients:  Seventeen patients aged 7 months to 14 years underwent laryngoscopy and bronchoscopy for evaluation or follow-up of upper airway obstruction or respiratory failure and were found to have supraglottic stenosis/collapse.

Main Outcome Measures:  Each patient's records were reviewed for the average age at the time of diagnosis, history of prematurity, evidence of gastroesophageal reflux, history of long-term intubation, and any associated medical problems. In addition, patients were compared based on previous airway surgery (tracheostomy, laryngotracheal reconstruction, or anterior cricoid split).

Results:  Chronic upper airway obstruction was identified in 17 patients caused by supraglottic stenosis/collapse. All patients (100%) had undergone tracheostomy prior to the recognition of supraglottic stenosis/collapse. Fifty-nine percent of the patients had undergone laryngotracheal reconstruction, and 53% had a history of gastroesophageal reflux.

Conclusion:  Supraglottic stenosis/collapse is a distinct entity that may be related to prior laryngeal or tracheal surgery. This diagnosis should be considered when evaluating and treating patients with chronic upper airway obstruction following laryngeal and/or tracheal surgery.Arch Otolaryngol Head Neck Surg. 1997;123:337-341