Experience with iatrogenic laryngeal and tracheal stenoses.

Experience with 38 patients with subglottic stenosis and two with tracheal stenosis is reviewed. The average age of patients in this series was 18 months and all developed their problem because of the need for endotracheal intubation and assisted ventilation. It was concluded that endotracheal intubation is safe in infants for up to 3 to 4 weeks but no longer than seven days in patients over 6 months of age. Since the presence of infection contributes to airway stenosis, the latter intervals should be shortened when this factor is present. While direct operative repair has been described for the management of subglottic and upper tracheal stenosis, serial endoscopic resection of scar, dilation and intralesional steroids have proven to be effective therapy in the vast majority of patients within 1 year of initiation of therapy.