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COCLIA Pediatrics: Glottic and Subglottic Stenosis Samuel Ostrower March 24, 2008
1.  Review the Cotton stenosis grading system
 
Cotton SGS Grading Schema ,[object Object],[object Object],[object Object],[object Object]
Subglottic Dimensions ,[object Object],[object Object],[object Object],[object Object]
2.  Compare and contrast pediatric vs. adult laryngeal anatomy
Embryology
Embryology
 
Adult vs. Pediatric Larynx ,[object Object],[object Object],[object Object]
3.  Review the histopathologic classification of congenital subglottic stenosis
Congenital SGS ,[object Object],[object Object]
Membranous SGS ,[object Object],[object Object],[object Object],[object Object]
Cartilaginous SGS ,[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
4.  List the etiologies of acquired laryngeal stenosis
Causes of Acquired Laryngeal Stenosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
5.  Discuss the different types of laryngeal stenosis
Types of Laryngeal Stenosis ,[object Object],[object Object],[object Object],[object Object]
Posterior Glottic Stenosis ,[object Object]
6.  Discuss the endoscopic management of glottic and subglottic stenosis. What are the contraindications to endoscopic management.
Endoscopic Dilation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Endoscopic CO 2  Laser Scar Excision ,[object Object],[object Object],[object Object],[object Object]
Situations in which Endoscopic Management Less Successful ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
7. When and how do you do a cricoid split? List the criteria for cricoid split.
Cricoid Split
Cricoid Split ,[object Object],[object Object],[object Object],[object Object],[object Object]
8. You are consulted on a difficult to extubate neonate with subglottic stenosis. The family refuses a tracheostomy because they have heard of the high incidence of M&M in this population. What other options do they have (medical and surgical)?
9. Describe the open surgical management of posterior glottic stenosis in children.
Posterior Cricoid Graft
The Use of Posterior Cricoid Grafting in Managing Isolated Posterior Glottic Stenosis in Children ,[object Object],[object Object],[object Object],Rutter, Cotton; Arch Otolaryngol Head Neck Surg 2004;130:137-139.
10. Discuss the pros and cons of single stage laryngotracheal reconstruction.
Single Stage LTR ,[object Object],[object Object]
Single Stage Laryngotracheal Reconstruction in Children ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gustafson et al. Otolaryngol Head Neck Surg 2000;123:430.
11. To stent or not to stent.
SSLTR Without Stenting ,[object Object],[object Object],[object Object],[object Object],[object Object],Younis, Lazar. Otolaryngol Head Neck Surg 2000;122:488.
Effect of Stenting after LTR in a SGS Model ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Jewett, et al. Otolaryngol Head Neck Surg 1997;116:358.
12. List important factors in prevention of laryngotracheal stenosis.
Gatroesophageal Reflux: A Critical Factor in Pediatric SGS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Halstead. Otolaryngol Head Neck Surg 1999;120:683.
13. Discuss the proper assessment for decannulation in the pediatric population.
Pediatric Decannulation ,[object Object],[object Object],[object Object],[object Object],[object Object]
14. What is the data on Mitomycin C and prevention of restenosis?
Mitomycin ,[object Object],[object Object],[object Object],[object Object]
Topical Mitomycin Application after LTR ,[object Object],[object Object],[object Object],[object Object],Hartnick et al. Ann Otol Laryngol 2001;110:1.
15. Identify complications related to airway management in children.
Airway Management of Children Requiring ET Intubation Prior to ICU ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Easley et al. Crit Care Med 2000;28:2058-2063.
16. Discuss the proper antimicrobial coverage in laryngotracheal stents.
Microbiology of Stents in LTR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Simoni, Wiatrak. Laryngoscope 2004;114:364-367.

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8737 Coclia 84 Glottic Ans Subglottic Stenosis

  • 1. COCLIA Pediatrics: Glottic and Subglottic Stenosis Samuel Ostrower March 24, 2008
  • 2. 1. Review the Cotton stenosis grading system
  • 3.  
  • 4.
  • 5.
  • 6. 2. Compare and contrast pediatric vs. adult laryngeal anatomy
  • 9.  
  • 10.
  • 11. 3. Review the histopathologic classification of congenital subglottic stenosis
  • 12.
  • 13.
  • 14.
  • 15.
  • 16. 4. List the etiologies of acquired laryngeal stenosis
  • 17.
  • 18. 5. Discuss the different types of laryngeal stenosis
  • 19.
  • 20.
  • 21. 6. Discuss the endoscopic management of glottic and subglottic stenosis. What are the contraindications to endoscopic management.
  • 22.
  • 23.
  • 24.
  • 25. 7. When and how do you do a cricoid split? List the criteria for cricoid split.
  • 27.
  • 28. 8. You are consulted on a difficult to extubate neonate with subglottic stenosis. The family refuses a tracheostomy because they have heard of the high incidence of M&M in this population. What other options do they have (medical and surgical)?
  • 29. 9. Describe the open surgical management of posterior glottic stenosis in children.
  • 31.
  • 32. 10. Discuss the pros and cons of single stage laryngotracheal reconstruction.
  • 33.
  • 34.
  • 35. 11. To stent or not to stent.
  • 36.
  • 37.
  • 38. 12. List important factors in prevention of laryngotracheal stenosis.
  • 39.
  • 40. 13. Discuss the proper assessment for decannulation in the pediatric population.
  • 41.
  • 42. 14. What is the data on Mitomycin C and prevention of restenosis?
  • 43.
  • 44.
  • 45. 15. Identify complications related to airway management in children.
  • 46.
  • 47. 16. Discuss the proper antimicrobial coverage in laryngotracheal stents.
  • 48.