[Treatment of laryngotracheal stenoses in children].

Over a period of 5 years, from 1984 to 1989, 35 children were treated surgically for a laryngo-tracheal stenosis, 27 by an external approach, 8 by endoscopy with the CO2 laser. Of the children, 25 (71%) were under 5 years old at the time of treatment and 77% of the stenoses (n = 27) corresponded to a post-intubation and/or tracheotomy acquired etiology. Based on the classification of stenoses according to the extent of the impairment of the aerial lumen, the authors stress the value of conservative treatment (endoscopy) in Stage I (less than 70%, n = 8), and of treatment using the external approach in Stage II (between 70% and 90%, n = 12), in Stage III (between 90% and 99%, n = 12) and Stage IV (complete obstruction, n = 3). The technique most widely used currently is laryngo-tracheoplasty with the insertion of costal cartilage (n = 17). Analysis of the results shows that decannulation was successful in 85% of the cases. With respect to the management of stenoses in the new-born baby, the authors report on their recent experience with laryngo-trachoe-fissure in 6 cases as an alternative either to tracheotomy in difficult extubations, or to laryngo-tracheoplasty when the child's weight is particularly low.