Severe Subglottic Tracheal Stenosis Dictates Intercontinental Transfer of a 2-Year-Old Child with Tracheostomy Tube In SituFunding All the authors declare that they did not receive any funding from any source for this case study.
22 October 2019 (online)
Atrioventricular septal defect (AVSD) is the most common congenital cardiac anomaly associated with Down’s syndrome. Children with AVSD develop pulmonary arterial hypertension and often require extensive therapy with pulmonary vasodilators in the postoperative period. The postoperative management is complicated by prolonged mechanical ventilation through endotracheal tube or tracheostomy tube. This artificial airway may trigger various airway complications including subglottic tracheal stenosis. The incidence and severity of subglottic tracheal stenosis is high in children with congenital syndromes. Inability to extubate or decannulate trachea and rapid respiratory compromise while attempting to do so directs toward a diagnosis of subglottic tracheal stenosis. The following case report discusses a 2–year-old boy from Nigeria who was discharged with tracheostomy tube in situ due to severe subglottic tracheal stenosis and surgical tracheoplasty could not be done at his present age. The implications of prolonged tracheostomy tube in situ and the hazards thereof during transfer of the child are being described.
- 1 Stoll C, Dott B, Alembik Y, Roth MP. Associated congenital anomalies among cases with Down syndrome. Eur J Med Genet 2015; 58 (12) 674-680
- 2 Allred C, Queimado L, Krempl G. Postintubation tracheal stenosis: case report and review of current management. J Case Rep Med 2013; 2: 1-3
- 3 Raman T, Chatterjee K, Alzghoul BN. et al. A bronchoscopic approach to benign subglottic stenosis. SAGE Open Med Case Rep 2017; 5: X17713151
- 4 Prasad KT, Dhooria S, Sehgal IS, Aggarwal AN, Agarwal R. Complete subglottic tracheal stenosis managed with rigid bronchoscopy and T-tube placement. Lung India 2016; 33 (06) 661-663
- 5 Pearson FG, Andrews MJ. Detection and management of tracheal stenosis following cuffed tube tracheostomy. Ann Thorac Surg 1971; 12 (04) 359-374
- 6 Karapantzos I, Karapantzou C, Zarogoulidis P, Tsakiridis K, Charalampidis C. Benign tracheal stenosis a case report and up to date management. Ann Transl Med 2016; 4 (22) 451
- 7 Feinstein AJ, Goel A, Raghavan G. et al. Endoscopic management of subglottic stenosis. JAMA Otolaryngol Head Neck Surg 2017; 143 (05) 500-505
- 8 Ciccone AM, De Giacomo T, Venuta F. et al. Operative and non-operative treatment of benign subglottic laryngotracheal stenosis. Eur J Cardiothorac Surg 2004; 26 (04) 818-822
- 9 Fudge JC, Li S, Jaggers J. et al. Congenital heart surgery outcomes in Down syndrome: analysis of a national clinical database. Pediatrics 2010; 126 (02) 315-322
- 10 Stauffer JL, Olson DE, Petty TL. Complications and consequences of endotracheal intubation and tracheotomy. A prospective study of 150 critically ill adult patients. Am J Med 1981; 70 (01) 65-76