Anesthesia for laryngotracheal reconstruction in children: A narrative review.

Amy J Lee, Jeremy D Prager, Tessa N Mandler, Debnath Chatterjee, Todd M Wine, Norah R Janosy

Journal: Paediatric anaesthesia 2023;33(11):883-893

PMID: 37408495

Abstract

Laryngotracheal stenosis, congenital or acquired, is a common cause of pediatric airway obstruction. Acquired subglottic stenosis frequently results from prolonged neonatal intubation. The clinical presentation of subglottic stenosis is variable, ranging from biphasic stridor and frequent upper respiratory infections to acute airway compromise. Optimal patient care requires clinical coordination within a multidisciplinary subspecialty team. Medical management includes optimizing respiratory status, gastroesophageal reflux, speech, feeding, nutrition therapies, and providing psychosocial support. If surgical intervention is required, the otolaryngologist, anesthesiologist, and perioperative team must collaborate closely to ensure successful operative outcomes. This narrative review of laryngotracheal stenosis will discuss the pathophysiology, clinical evaluation, medical management, and surgical interventions, and focus on the perioperative anesthetic considerations for children undergoing laryngotracheal reconstruction.

© 2023 John Wiley & Sons Ltd.

Address: Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA.; Department of Otolaryngology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA.
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