Abstract
Acquired supraglottic stenosis is a rare, but potential late sequela of corrosive injury, usually occurring 1 to 2 months after the initial trauma. The presentation may be delayed in children and is potentially lethal. We describe two pediatric patients, aged 31 and 16 months, who developed progressive inspiratory stridor and hoarseness about 2 months after accidental alkali ingestion. Fiberoptic laryngoscopy showed supraglottic stenosis. Intubation was achieved with a very small endotracheal tube under fiberoptic laryngobronchoscopic guidance prior to general anesthesia. Both patients successfully underwent CO2 laser treatment under direct laryngoscopic guidance. There has been no case of recurrence reported after 1 year of follow-up other than a thin membranous scar in one case at the 3rd month of follow-up, which was easily dealt with by bronchoscopy dilatation. For such patients, monthly laryngoscopic examinations are advisable after alkaline corrosive injury for a minimum of 6 months. Prompt diagnosis and early airway intervention can reduce the need for tracheostomy and decrease the mortality rate.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Solomons NB, Prescott CAJ (1987) Laryngomalacia: a review and the surgical management for severe cases. Int J Pediatr Otorhinolaryngol 13:31–39
Walner DL, Holinger LD (1997) Supraglottic stenosis in infants and children: a preliminary report. Arch Otolaryngol Head Neck Surg 123:337–341
Ferguson MK, Migliore M, Staszak DM, Little AG (1989) Early evaluation and therapy for caustic esophageal injury. Am J Surg 157:116–120
Sugawa C, Lucas CE (1989) Caustic injury of the upper gastrointestinal tract in adults: a clinical and endoscopic study. Surgery 106:802–807
Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK (1992) Ingestion of strong corrosive alkalis: spectrum of injury to upper gastrointestinal tract and nature history. Am J Gastroenterol 87:337–341
Makela JT, Laitinen S, Salo JA (1998) Corrosion injury of the upper gastrointestinal tract after swallowing strong alkali. Eur J Surg 164:575–580
Lesperance MM, Zalzal GH (1998) Laryngotracheal stenosis in children. Eur Arch Otorhinolaryngol 255:12–17
Middlekamp JN, Ferguson TB, Roper CL, Hoffman FD (1989) The management and problem of caustic burns in children. Am J Surg 157:116–120
Walker, Durie, Hamilton, Walker-Smith, Watkins (2000) Pediatric gastrointestinal disease, 3rd edn. Decker, Canada, pp 357–362
Isolauri J, Markkula H (1989) Lye ingestion and carcinoma of the oesophagus. Acta Chir Scand 155:269–271
Dantas RO, Mamede RCM (1996) Oesophageal motility in patients with oesophageal caustic injury. Am J Gastroenterol 91:1157–1161
Langmore SE (2001) Endoscopic evaluation and treatment of swallowing disorders. Thieme, New York, pp 50–59
Simpson GT, Strong MS, Healy GB, Shapshay SM, Vaughan CW (1982) Predictive factors of success or failure in the endoscopic management of laryngeal and tracheal stenosis. Ann Otol Rhinol Laryngol 91:384–388
Bailey M, Hoeve H, Monnier P (2003) Paediatric laryngotracheal stenosis: a consensus paper from three European centres. Eur Arch Otorhinolaryngol 260:118–123
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Chen, YW., Lai, SH., Fang, TJ. et al. Pediatric dyspnea caused by supraglottic stenosis: a rare complication of alkali corrosive injury. Eur Arch Otorhinolaryngol 263, 210–214 (2006). https://doi.org/10.1007/s00405-005-1011-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-005-1011-5