Skip to main content
SpringerLink
Log in

Neonatal Subglottic Stenosis

  • Chapter
  • First Online:
Disorders of the Neonatal Airway

Abstract

Subglottic stenosis is classified as congenital or acquired based on a history of prior airway instrumentation. Milder cases can often be managed with medical support and endoscopic procedures, while patients with more pronounced narrowing may require open surgical repair. The most severe form of stenosis—laryngeal atresia—requires immediate recognition and management in the delivery room. Patients with subglottic stenosis can benefit from multidisciplinary evaluation and management coincident pathology in the upper aerodigestive tract.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Walner DL, Loewen MS, Kimura RE. Neonatal subglottic stenosis—incidence and trends. Laryngoscope. 2001;111(1):48–51.

    Article  CAS  PubMed  Google Scholar 

  2. Leung R, Berkowitz RG. Incidence of severe acquired subglottic stenosis in newborns. Int J Pediatr Otorhinolaryngol. 2007;71(5):763–8. Epub 2007 Feb 21.

    Article  PubMed  Google Scholar 

  3. Suzumura H, Nitta A, Tanaka G, Kuwashima S, Hirabayashi H. Role of infection in the development of acquired subglottic stenosis in neonates with prolonged intubation. Pediatr Int. 2000;42(5):508–13.

    Article  CAS  PubMed  Google Scholar 

  4. Duynstee ML, de Krijger RR, Monnier P, Verwoerd CD, Verwoerd-Verhoef HL. Subglottic stenosis after endolaryngeal intubation in infants and children: result of wound healing processes. Int J Pediatr Otorhinolaryngol. 2002;62(1):1–9.

    Article  CAS  PubMed  Google Scholar 

  5. Gould SJ, Howard S. The histopathology of the larynx in the neonate following endotracheal intubation. J Pathol. 1985;146:301–11.

    Article  CAS  PubMed  Google Scholar 

  6. Manica D, Schweiger C, Maróstica PJ, Kuhl G, Carvalho PR. Association between length of intubation and subglottic stenosis in children. Laryngoscope. 2013;123(4):1049–54. doi:10.1002/lary.23771. Epub 2013 Feb 1.

    Article  PubMed  Google Scholar 

  7. da Silva OP. Factors influencing acquired upper airway obstruction in newborn infants receiving assisted ventilation because of respiratory failure: an overview. J Perinatol. 1996;16(4):272–5.

    CAS  PubMed  Google Scholar 

  8. Myer 3rd CM, O’Connor DM, Cotton RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol. 1994;103(4 Pt 1):319–23.

    Article  PubMed  Google Scholar 

  9. Zalzal GH, Choi SS, Patel KM. The effect of gastroesophageal reflux on laryngotracheal reconstruction. Arch Otolaryngol Head Neck Surg. 1996;122(3):297–300.

    Article  CAS  PubMed  Google Scholar 

  10. Roh JL, Lee YW, Park HT. Effect of acid, pepsin, and bile acid on the stenotic progression of traumatized subglottis. Am J Gastroenterol. 2006;101(6):1186–92.

    Article  PubMed  Google Scholar 

  11. Blumin JH, Johnston N. Evidence of extraesophageal reflux in idiopathic subglottic stenosis. Laryngoscope. 2011;121(6):1266–73. doi:10.1002/lary.21776.Epub2011May6.

    Article  PubMed  Google Scholar 

  12. Edmondson NE, Bent 3rd J. Serial intralesional steroid injection combined with balloon dilation as an alternative to open repair of subglottic stenosis. Int J Pediatr Otorhinolaryngol. 2010;74(9):1078–81.

    Article  PubMed  Google Scholar 

  13. Hebra A, Powell DD, Smith CD, Othersen Jr HB. Balloon tracheoplasty in children: results of a 15-year experience. J Pediatr Surg. 1991;26(8):957–61.

    Article  CAS  PubMed  Google Scholar 

  14. Ransom ER, Antunes MB, Smith LP, Jacobs IN. Microdebrider resection of acquired subglottic cysts: case series and review of the literature. Int J Pediatr Otorhinolaryngol. 2009;73(12):1833–6.

    Article  PubMed  Google Scholar 

  15. White DR, Bravo M, Vijayasekaran S, Rutter MJ, Cotton RT, Elluru RG. Laryngotracheoplasty as an alternative to tracheotomy in infants younger than 6 months. Arch Otolaryngol Head Neck Surg. 2009;135(5):445–7. doi:10.1001/archoto.2009.21.

    Article  PubMed  Google Scholar 

  16. Fayoux P, Devisme L, Merrot O, Chevalier D. Thyroid alar cartilage graft in laryngoplasty: anatomical study in premature and newborn babies. Int J Pediatr Otorhinolaryngol. 2002;66(3):259–63.

    Article  PubMed  Google Scholar 

  17. Forte V, Chang MB, Papsin BC. Thyroid ala cartilage reconstruction in neonatal subglottic stenosis as a replacement for the anterior cricoid split. Int J Pediatr Otorhinolaryngol. 2001;59(3):181–6.

    Article  CAS  PubMed  Google Scholar 

  18. Richardson MA, Inglis Jr AF. A comparison of anterior cricoid split with and without costal cartilage graft for acquired subglottic stenosis. Int J Pediatr Otorhinolaryngol. 1991;22(2):187–93.

    Article  CAS  PubMed  Google Scholar 

  19. Jiang D, Morrison GA. The influence of long-term tracheostomy on speech and language development in children. Int J Pediatr Otorhinolaryngol. 2003;67 Suppl 1:S217–20.

    Article  PubMed  Google Scholar 

  20. Ikonomidis C, George M, Jaquet Y, Monnier P. Partial cricotracheal resection in children weighing less than 10 kilograms. Otolaryngol Head Neck Surg. 2010;142(1):41–7.

    Article  PubMed  Google Scholar 

  21. Hartley BE, Cotton RT. Paediatric airway stenosis: laryngotracheal reconstruction or cricotracheal resection? Clin Otolaryngol Allied Sci. 2000;25(5):342–9.

    Article  CAS  PubMed  Google Scholar 

  22. Wetmore RF, Marsh RR, Thompson ME, Tom LW. Pediatric tracheostomy: a changing procedure? Ann Otol Rhinol Laryngol. 1999;108(7 Pt 1):695–9.

    Article  CAS  PubMed  Google Scholar 

  23. Carr MM, Poje CP, Kingston L, Kielma D, Heard C. Complications in pediatric tracheostomies. Laryngoscope. 2001;111(11 Pt 1):1925–8.

    Article  CAS  PubMed  Google Scholar 

  24. Demauro SB, D’Agostino JA, Bann C, Bernbaum J, Gerdes M, Bell EF, Carlo WA, C’Angio CT, Das A, Higgins R, Hintz SR, Laptook AR, Natarajan G, Nelin L, Poindexter BB, Sanchez PJ, Shankaran S, Stoll BJ, Truog W, Van Meurs KP, Vohr B, Walsh MC, Kirpalani H, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Developmental outcomes of very preterm infants with tracheostomies. J Pediatr. 2014;164(6):1303–10.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Lyons M, Vlastarakos PV, Nikolopoulos TP. Congenital and acquired developmental problems of the upper airway in newborns and infants. Early Hum Dev. 2012;88(12):951–5.

    Article  PubMed  Google Scholar 

  26. Schroeder Jr JW, Holinger LD. Congenital laryngeal stenosis. Otolaryngol Clin North Am. 2008;41(5):865–75.

    Article  PubMed  Google Scholar 

  27. Artunc Ulkumen B, Pala HG, Nese N, Tarhan S, Baytur Y. Prenatal diagnosis of congenital high airway obstruction syndrome: report of two cases and brief review of the literature. Case Rep Obstet Gynecol. 2013;2013:728974.

    PubMed  PubMed Central  Google Scholar 

  28. Vanhaesebrouck P, De Coen K, Defoort P, et al. Evidence for autosomal dominant inheritance in prenatally diagnosed CHAOS. Eur J Pediatr. 2006;165(10):706–8.

    Article  PubMed  Google Scholar 

  29. Hedrick MH, Ferro MM, Filly RA, Flake AW, Harrison MR, Adzick NS. Congenital high airway obstruction syndrome (CHAOS): a potential for perinatal intervention. J Pediatr Surg. 1994;29(2):271–4.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Otolaryngology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Kara K. Prickett M.D.

  2. Division of Otolaryngology, The Children’s Hospital of Philadelphia, Department of Otorhinolaryngology—Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA

    Ian N. Jacobs M.D.

Authors
  1. Kara K. Prickett M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ian N. Jacobs M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ian N. Jacobs M.D. .

Editor information

Editors and Affiliations

  1. Attending Neonatologist, Director Neonatal Outreach, Medical Director, Neonatal Airway Program, The Children’s Hospital of Philadelphia, Associate Professor of Clinical Pediatrics, Department of Neonatology, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA

    Janet Lioy

  2. Attending Surgeon, Fellowship Director, Pediatric Otolaryngology, The Center for Pediatric Airway Disorders, The Children’s Hospital of Philadelphia, Associate Professor, Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA

    Steven E. Sobol

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this chapter

Cite this chapter

Prickett, K.K., Jacobs, I.N. (2015). Neonatal Subglottic Stenosis. In: Lioy, J., Sobol, S. (eds) Disorders of the Neonatal Airway. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1610-8_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-1610-8_7

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1609-2

  • Online ISBN: 978-1-4939-1610-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation