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Pediatric Surgery International

, Volume 23, Issue 11, pp 1033–1044 | Cite as

The current state of congenital tracheal stenosis

  • P. Herrera
  • C. Caldarone
  • V. Forte
  • P. Campisi
  • H. Holtby
  • P. Chait
  • P. Chiu
  • P. Cox
  • S.-J. Yoo
  • D. Manson
  • P. C. W. Kim
Review Article

Abstract

Congenital tracheal stenosis (CTS) is an uncommon condition that has challenged pediatric surgeons for decades. Patients with CTS can present with a wide spectrum of symptoms and varying degrees of severity. In addition, a variety of techniques have been devised to repair this malformation. A review of these procedures and our suggestions for clinical standards and practice guidelines will be presented in this paper. A retrospective review of the literature on CTS from 1964 to 31 March, 2006. There is not one standard technique for the repair of CTS, as individualized approach to each patient and airway lesion is necessary to optimize patient management; nevertheless there is a consensus about segmental resection and anastomosis being best for short segment stenosis while slide tracheoplasty is most effective for the long-segment ones. Conservative management is also an option for select group of patients with careful and close follow up. Survival following surgery over the years has improved, but mortality remained high, particularly in a specific subset of patients presenting at the age less than 1 month with associated cardiac malformations. In conclusion, CTS remains a significant challenge for pediatric surgeons. Additional research is required to improve our understanding of the pathogenesis of CTS, and to develop evidence-based treatment protocols for the entire spectrum of presentation including conservative management.

Keywords

Congenital tracheal stenosis Slide tracheoplasty Conservative management Tracheal embryology 

Notes

Acknowledgement

We would like to kindly thank Dr. Sigmund H. Ein, for his endless sense of humor and his valuable and insightful comments on this manuscript.

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • P. Herrera
    • 1
    • 2
  • C. Caldarone
    • 1
  • V. Forte
    • 1
  • P. Campisi
    • 1
  • H. Holtby
    • 1
  • P. Chait
    • 1
  • P. Chiu
    • 1
  • P. Cox
    • 1
  • S.-J. Yoo
    • 1
  • D. Manson
    • 1
  • P. C. W. Kim
    • 1
  1. 1.The Airway Reconstruction Team, The Hospital for Sick ChildrenTorontoCanada
  2. 2.SantiagoChile

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