Diagnosis and management of pediatric tracheal stenosis.

Pediatric tracheal stenosis is a difficult problem that requires very careful preoperative evaluation and classification. Most forms of extrinsic compression are vascular in origin but can be associated with tracheomalacia, complete tracheal rings, and other anomalies of the aerodigestive tract. Optimally, both the vascular malformation and the intrinsic tracheal malformation should be repaired at the same procedure. Long tracheal stenosis, most commonly caused by complete tracheal rings, is best treated by pericardial patch tracheoplasty or cartilage augmentation. Areas of short-segment intrinsic stenosis can sometimes be corrected endoscopically with or without intraluminal stenting, depending on severity. When endoscopic methods fail, resection with end-to-end anastomosis is the procedure of choice for short-segment stenosis.