Glottic and Subglottic Stenosis

6.6.1 Review the cotton stenosis grading system.

6.6.2 Compare and contrast pediatric vs. adult laryngeal anatomy.

6.6.3 Review the histopathologic classification of congenital subglottic stenosis.

6.6.4 List the etiologies of acquired laryngeal stenosis.

6.6.5 Discuss the different types of laryngeal stenosis. 

6.6.6 Discuss the endoscopic management of glottic and subglottic stenosis. What are the contraindications to endoscopic management.

6.6.7 When and how do you do a cricoid split? List the criteria for cricoid split.

6.6.8 You are consulted on a difficult to extubate neonate with subglottic stenosis. The family refuses a tracheostomy because they have heard of the high incidence of M&M in this population. What other options do they have (medical and surgical)?

6.6.9 Describe the open surgical management of posterior glottic stenosis in children.

6.6.10 Discuss the pros and cons of single stage laryngotracheal reconstruction.

Gustafson LM, Hartley BE, Liu JH, Link DT, Chadwell J, Koebbe C, Myer CM 3rd, Cotton RT. Single-stage laryngotracheal reconstruction in children: a review of 200 cases. Otolaryngol Head Neck Surg. 2000 Oct;123(4):430-Review. PMID:11020180

6.6.11 To stent or not to stent.

Jewett BS, Cook RD, Johnson KL, Logan TC, Shockley WW. Effect of stenting after laryngotracheal reconstruction in a subglottic stenosis model. Otolaryngol Head Neck Surg. 2000 Apr;122(4):488-94. PMID:10740166

Younis RT, Lazar RH. Laryngotracheal reconstruction without stenting. Otolaryngol Head Neck Surg. 1997 Mar;116(3):358-62. PMID:9121791

6.6.12 List important factors in prevention of laryngotracheal stenosis.

Halstead LA. Gastroesophageal reflux: A critical factor in pediatric subglottic stenosis. Otolaryngol Head Neck Surg. 1999 May;120(5):683-8. PMID:10229593

6.6.13 Discuss the proper assessment for decannulation in the pediatric population.

6.6.14 What is the data on Mitomycin Cand prevention of restenosis?

Rahbar R, Shapshay SM, Healy GB. Mitomycin: effects on laryngeal and tracheal stenosis, benefits, and complications.Ann Otol Rhinol Laryngol. 2001 Jan;110(1):1-6. PMID:11201800

6.6.15 Identify complications related to airway management in children.

Easley RB, Segeleon JE, Haun SE, Tobias JD. Prospective study of airway management of children requiring endotracheal intubation before admission to a pediatric intensive care unit. Crit Care Med. 2000 Jun;28(6):2058-63. PMID:10890664

6.6.16 Discuss the proper antimicrobial coverage in laryngotracheal stents.

Simoni P, Wiatrak BJ. Microbiology of stents in laryngotracheal reconstruction. Laryngoscope. 2004 Feb;114(2):364-7. PMID:14755219