Laryngoplasty with T-tube stenting in the treatment of subglottic stenosis in children

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Abstract

Introduction. Laryngeal stenosis is a congenital or acquired narrowing of the larynx that causes airway obstruction. Approximately 90% of cases of acquired subglottic stenosis in infants and children are due to endotracheal intubation. Laryngotracheoplasty with T-tube placement is a method for treating laryngotracheal stenosis.

Aim. To demonstrate our experience of treating children with stenosis of the subglottic space using laryngoplasty with T-tube placement.

Materials and methods. 53 patients with postintubation laryngeal stenosis are treating in the surgical thoracic department of the National Medical Research Center for Children's Health for the period from 2019 until now. All children were examined. 33 patients underwent laryngoplasty with T-tube stenting.

Results. Nowadays, 18 children have been decannulated after laryngoplasty with T-tube stenting, the rest of the patients continue their treatment.

Conclusion. According to our materials, T-tube stenting is safe and can be an alternative method for treating children with severe acquired laryngeal stenosis.

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About the authors

Elena I. Komina

National Medical Research Center for Children's Health

Author for correspondence.
Email: kominaalena@gmail.com
ORCID iD: 0000-0002-9808-8682

Graduate Student

Russian Federation, 119991, Moscow, Lomonosovskiy pr. 2, str. 1

Abdumanap B. Alkhasov

National Medical Research Center for Children's Health; Pirogov Russian National Research Medical University

Email: alkhasov.ab@nczd.ru
ORCID iD: 0000-0003-3925-4991

D. Sci. (Med.)

Russian Federation, 119991, Moscow, Lomonosovskiy pr. 2, str. 1; 117997, Moscow, Ostrovityanova str. 1

Yuri Yu. Rusetski

National Medical Research Center for Children's Health; Central State Medical Academy of the President of the Russian Federation

Email: rusetski@inbox.ru
ORCID iD: 0000-0001-5574-8292

D. Sci. (Med.)

Russian Federation, 119991, Moscow, Lomonosovskiy pr. 2, str. 1; Moscow

Sergei P. Yatsyk

National Medical Research Center for Children's Health

Email: yatsyk@nczd.ru
ORCID iD: 0000-0002-0764-1287

D. Sci. (Med.), Prof., Corr. Memb. RAS

Russian Federation, 119991, Moscow, Lomonosovskiy pr. 2, str. 1

Maksim M. Lokhmatov

National Medical Research Center for Children's Health; Sechenov First Moscow State Medical University (Sechenov University)

Email: lokhmatov@nczd.ru
ORCID iD: 0000-0002-8305-7592

D. Sci. (Med.)

Russian Federation, 119991, Moscow, Lomonosovskiy pr. 2, str. 1; 119991, Moscow, Trubetskaya str. 8, str. 2

Sergey A. Ratnikov

National Medical Research Center for Children's Health

Email: 6193141@gmail.com
ORCID iD: 0000-0003-2082-3998

pediatric surgeon

Russian Federation, 119991, Moscow, Lomonosovskiy pr. 2, str. 1

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Supplementary files

Supplementary Files
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1. Fig. 1. Fiberoptic bronchoscopy: stenosis of the larynx III degree according to the Mayer–Cotton scale.

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2. Fig. 2. Multislice computed tomography: extended stenosis of the subglottic space.

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3. Fig. 3. The back wall of the larynx is dissected.

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4. Fig. 4. The scar is excised, the lumen of the larynx is expanded.

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5. Fig. 5. A T-shaped tube is installed in the lumen of the larynx and trachea.

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6. Fig. 6. The result of treatment of a child with a combination of II degree laryngeal stenosis and laryngeal paresis.

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