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- Title
Management of Paediatric Laryngotrachealstenosis and Outcome in Universiti Kebangsaan Malaysia Medical Center.
- Authors
Bee See Goh; Mesran, Izham; Zahedi, Farah Dayana
- Abstract
Objective: This study aimed to describe the management and outcome of paediatric Laryngotracheal Stenosis (LTS) in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from 2001 to 2015. Design: This is a retrospective study. Universal sampling technique was used in this study. Materials and methods: We have determined the common causes of paediatric LTS, predicting prognosis and progress of disease and could plan for future management for paediatric patient with LTS. Patients' characteristics by age, gender, race and prematurity were extracted from records. The etiology of stenosis, the treatment and the treatment outcome were studied. Samples were taken from UKMMC Otorhinolaryngology clinic, a tertiary center that received referral cases from various medical centers. Results: A total of 30 patients (17 males and 13 females) with the mean age of 4years 3month old were identified. The most common type was acquired which comprise of 86.7%, followed by congenital 10% and mixed stenosis of 3.3%. The majority of cases had stenosis Cotton-Myer grade 111 (43.3%), followed by grade 1 (30.0%), grade 11 (20.0%) and grade IV (6.7%). The most common site involved was subglottic (70%). The criteria for successful treatment were successful decannulation 6 months after treatment. From the total number of 20 patients with tracheostomy, 11 patients were successfully decanulated (decannulation rate of 55"/o) while 8 patient were not decannulated and 1 patient past away due to non related cause. More than half of patients were treated endoscopically (n = 24, 80%) while 6 patient undergone open surgery. From the open surgery, Partial Cricotracheal Resection and Anastomosis (PCTR) had given the success rate of 50% at 6 months and became 100% after 2 years. Conclusion: Management of paediatric LTS is technically challenged due to diversity of clinical presentations, complex associated anomalies with rarity of the disorder. Success of surgery requires careful evaluation of the entire airway and decision making.
- Subjects
MALAYSIA; ACADEMIC medical centers; AGE distribution; ENDOSCOPY; PREMATURE infants; EVALUATION of medical care; LARYNGEAL diseases; MEDICAL referrals; OTOLARYNGOLOGY; POSTOPERATIVE period; RACE; SEX distribution; TRACHEOTOMY; DECISION making in clinical medicine; TRACHEAL diseases; DISEASE management; TREATMENT effectiveness; RETROSPECTIVE studies; STENOSIS; SURGICAL anastomosis; TERTIARY care; CHILDREN; PROGNOSIS; DIAGNOSIS
- Publication
International Medical Journal, 2018, Vol 25, Issue 5, p323
- ISSN
1341-2051
- Publication type
Article