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1.
Orv Hetil ; 162(52): 2100-2106, 2021 12 26.
Artigo em Húngaro | MEDLINE | ID: mdl-34962487

RESUMO

Összefoglaló. A veleszületett légúti szukületek gyakran kombináltan jelentkeznek, és más szervrendszert is érinto kísérobetegségekkel, illetve malformációkkal is társulhatnak. Figyelembe véve ezeket a tényezoket, illetve a csecsemokori légút speciális anatómiáját és sérülékeny szöveteit, a felso légúti szukületek sebészi kezelése újszülött- és csecsemokorban igen nagy kihívást jelento feladat, melynek célja a mihamarabbi definitív, stabil légút biztosítása a hangképzés és a nyelési funkció megorzésével. A laryngomalacia, a hangszalagbénulás és a subglotticus stenosis együttesen a gége veleszületett rendellenességeinek megközelítoleg 90%-áért felelos. A szerzok erre a három kórképre fókuszálva egy-egy eset kapcsán bemutatják a Szegedi Tudományegyetem Fül-Orr-Gégészeti és Fej-Nyaksebészeti Klinikáján muködo légútsebészeti munkacsoport által rutinszeruen alkalmazott innovatív sebészi módszereket. A bemutatott sebészeti megoldások egy lépésben, tracheostoma, sztentelés és graft beültetése nélkül azonnali stabil légutat biztosítanak jó hangminoséggel és nyelési funkcióval a supraglottis, a glottis és a subglottis dinamikus és statikus szukületei esetén egyaránt. Orv Hetil. 2021; 162(52): 2100-2106. Summary. Congenital airway stenoses occur frequently in combinations or may be associated with comorbidities and malformations affecting other organ systems. Considering these factors as well as the special anatomy and vulnerable tissues of the pediatric airway, surgical treatment in neonates and infants is an extremely challenging task. The ultimate goal of the management is to ensure a definitive and adequate airway as soon as possible with the preservation of voice and swallowing. Laryngomalacia, vocal cord palsy and subglottic stenosis together account for approximately 90% of congenital laryngeal disorders. Focusing on these three diseases, the authors - the airway surgery working group at the Department of Otolaryngology and Head and Neck Surgery, University of Szeged, Hungary - present their routinely applied innovative surgical strategies in connection with three cases. The presented 'one-step' surgical solutions provide immediate stable airway with good voice quality and swallowing function without tracheostomy, stenting, or graft implantation for both dynamic and static stenoses of the supraglottis, glottis, and subglottis. Orv Hetil. 2021; 162(52): 2100-2106.


Assuntos
Laringoestenose , Paralisia das Pregas Vocais , Criança , Humanos , Hungria , Recém-Nascido , Laringoestenose/cirurgia , Motivação , Qualidade da Voz
2.
Vestn Otorinolaringol ; 86(6): 57-61, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34964331

RESUMO

Laryngeal cysts in children are relatively rare, occupying the 4-5th place in the structure of congenital malformations. The paper presents the combined experience of two Russian pediatric otorhinolaryngological clinics traditionally involved in the rehabilitation of patients with congenital and acquired pathology of the larynx. OBJECTIVE: To analyze the features of the clinic, diagnosis and treatment of laryngeal cysts in children. MATERIAL AND METHODS: The study included 68 children with laryngeal cysts aged from 3 days to 16 years (on average 39.5±37.0 months, Me=15.5 months). The cyst was localized in the vestibular region of the larynx in 15 (22.1%) patients, in the vocal region - in 15 (22.1%) patients, and in the sub-vocal region - in 38 (55.9%) patients. Data on the presence of a history of tracheal intubation were available in 35 (89.7%) children, including 35 (92.1%) of 38 children with a subfold cyst. 11 patients were admitted with a previously applied tracheostomy. RESULTS: The main reasons for going to the clinic were signs of laryngeal stenosis (stridor, signs of obstruction of the upper airways) in 60.3% of patients, dysphonia - in 33.8%, and in 5.9%, the detection of a cyst became an accidental finding. To eliminate the cyst, the method of laser marsupialization was used in 10 patients, coagulatory ablation - in 2 patients, in the remaining 56 patients, decortication was performed with microinstruments, followed by laser treatment of the cyst bed. In the follow-up, children were traced from 6 months to 7 years. We did not observe a recurrence of a cyst in any case. CONCLUSION: Currently, the lining department is the "favorite" localization of the cyst in childhood. Subclavian cysts are more common in preterm infants who need tracheal intubation. A necessary condition for radical elimination is the resection of the cyst walls.


Assuntos
Cistos , Doenças da Laringe , Laringoestenose , Criança , Cistos/diagnóstico , Cistos/cirurgia , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Doenças da Laringe/diagnóstico , Doenças da Laringe/cirurgia , Laringoscopia , Laringoestenose/diagnóstico , Laringoestenose/etiologia , Laringoestenose/cirurgia
3.
J Card Surg ; 36(12): 4597-4603, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34647349

RESUMO

BACKGROUND AND AIM OF THE STUDY: Long-term laryngotracheal complications have not been described in adult patients undergoing cardiac surgery. The purpose of this study was to determine the incidence of and risk factors for laryngotracheal complications following cardiac surgery. METHODS: A retrospective chart review of patients at high risk for laryngotracheal complications following cardiac surgery between 2006 and 2016 was performed. High-risk patients were reviewed to determine the presence of laryngotracheal complications including laryngotracheal stenosis, keyhole deformity, or vocal cord immobility. Logistic regression was used to identify predictors of long-term laryngotracheal complications. RESULTS: Of 11,417 patients who underwent cardiac surgery, 1099 were identified as at high risk. Of these, 24 (2.2%) developed laryngotracheal complications following their surgery and intensive care unit (ICU) stay. Laryngotracheal stenosis and keyhole deformity were present in 13 (1.2%) and 6 (0.5%) patients, respectively. Logistic regression demonstrated older age (age ≥ 70 odds ratio [OR] 0.31, 95% confidence interval [CI] 0.12-0.83) was protective, while readmission to ICU for ventilation (OR 3.11, 95% CI 1.17-8.25) and receiving a tracheostomy (OR 7.83, 95% CI 2.22-27.6) were associated with laryngotracheal complications. CONCLUSIONS: The incidence of long-term laryngotracheal complications following cardiac surgery was 2.2%. Readmission to ICU for ventilation and having a tracheostomy performed were associated with laryngotracheal complications.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Laringoestenose , Estenose Traqueal , Adulto , Idoso , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Humanos , Laringoestenose/epidemiologia , Laringoestenose/etiologia , Laringoestenose/cirurgia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Fatores de Risco , Estenose Traqueal/epidemiologia , Estenose Traqueal/etiologia , Estenose Traqueal/cirurgia , Traqueostomia/efeitos adversos
5.
J Laryngol Otol ; 135(10): 897-903, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34384506

RESUMO

OBJECTIVE: This study aimed to compare treatment outcomes in patients with laryngeal and tracheal stenosis treated during and prior to the coronavirus disease 2019 pandemic period. METHOD: Patients treated for laryngotracheal lesions with impending airway compromise during the active pandemic period were matched with those treated for similar lesions in the preceding years in a monocentric tertiary hospital setting. RESULTS: During the pandemic period of 55 days, 31 patients underwent 47 procedures. Seven patients (2 children, 5 adults) had open airway surgery, and one had an operation-specific complication. Twenty-four patients (10 children, 14 adults) underwent 40 endoscopic interventions without any complications. Operation specific results during and prior to the pandemic were comparable. CONCLUSION: The management strategy in patients with laryngotracheal lesions and impending airway compromise should not be altered during periods of risk from coronavirus disease 2019. Avoiding a tracheostomy by performing primary corrective surgery or proceeding with a definitive decannulation would be beneficial in these patients to reduce the risk of contagion.


Assuntos
COVID-19/transmissão , Endoscopia/estatística & dados numéricos , Laringoestenose/cirurgia , Estenose Traqueal/cirurgia , Adulto , Idoso , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/virologia , Cateterismo/efeitos adversos , Pré-Escolar , Tomada de Decisão Clínica/ética , Endoscopia/efeitos adversos , Feminino , Humanos , Masculino , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , SARS-CoV-2/genética , Centros de Atenção Terciária/estatística & dados numéricos , Traqueostomia/efeitos adversos , Resultado do Tratamento
6.
BMJ Case Rep ; 14(8)2021 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-34380670

RESUMO

We describe a case of a 15-year-old girl diagnosed with relapsing polychondritis (RP) with involvement of the tracheobronchial tree, resulting in an increased difficulty in breathing, hoarseness of voice and stridor.Her case required the input of multiple specialities including ear, nose and throat, rheumatology, respiratory team and intensive care. Airway assessment and imaging showed glottic and subglottic stenosis and left bronchomalacia. Despite the use of steroids, cyclophosphamide and rituximab, her symptoms progressed and she was started on overnight non-invasive ventilation.She had further relapses of her airway RP-she was started on adalimumab and methotrexate and underwent monthly balloon dilatations which helped with her symptoms and facilitated a safe discharge home. However, she had further relapses and intensive care admissions and following further discussions, a tracheostomy was inserted. She is now stable on her tracheostomy and is off any respiratory support.


Assuntos
Laringoestenose , Policondrite Recidivante , Adolescente , Brônquios , Feminino , Humanos , Laringoestenose/etiologia , Laringoestenose/terapia , Policondrite Recidivante/complicações , Policondrite Recidivante/diagnóstico , Policondrite Recidivante/tratamento farmacológico , Sons Respiratórios/etiologia , Traqueostomia
8.
Vestn Otorinolaringol ; 86(3): 52-55, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34269024

RESUMO

Purpose is to study the long-term results of patients with cicatricial stenosis of the larynx treated with use lyophilized xenodermoimplants for postoperative wound plasty. MATERIAL AND METHODS: The results of treatment of 34 patients (age from 32 to 56 years) with cicatricial stenosis of the larynx were analyzed. A fundamentally new method of surgical treatment of such patients has been developed and introduced into practice, in which lyophilized xenodermoimplants were used for plasty of the wound surface. RESULTS: The proposed technique made it possible in the immediate postoperative period to obtain a good result in 28 (82.4%) patients, satisfactory - in 6 (17.6%). The length of hospital stay was reduced by 8-10 days. In the long-term period (after 6-11 years), 27 patients were examined. Of these, 21 (77.8%) obtained a good result, and 6 (22.2%) - satisfactory. CONCLUSION: The proposed method of surgical rehabilitation of the respiratory function of the larynx with its cicatricial stenosis using lyophilized xenodermoimplants is quite effective and can be proposed for use in clinical practice.


Assuntos
Laringoestenose , Laringe , Adulto , Constrição Patológica , Humanos , Laringoestenose/diagnóstico , Laringoestenose/etiologia , Laringoestenose/cirurgia , Laringe/cirurgia , Pessoa de Meia-Idade , Período Pós-Operatório , Respiração
10.
Laryngoscope ; 131(12): E2841-E2848, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34309022

RESUMO

OBJECTIVES/HYPOTHESIS: We sought to establish normative peak expiratory flow (PEF) data for patients with idiopathic subglottic stenosis (iSGS), evaluate whether immediate changes in PEF after a procedure predict long-term treatment response, and test if a decline in longitudinal PEF is associated with disease recurrence. STUDY DESIGN: International, prospective, 3-year multicenter cohort study of 810 patients with untreated, newly diagnosed, or previously treated iSGS. METHODS: iSGS patients consented and enrolled in the North American Airway Collaborative (NoAAC) iSGS1000 cohort recorded PEF data on a mobile smartphone app. Cox regression tested the associations between the magnitude of postoperative PEF improvement and longitudinal 90-day PEF decline with the risk of disease recurrence. RESULTS: Within the NoAAC iSGS1000 cohort, 810 patients participated in a 3-year prospective study comparing surgical treatment efficacy and 385 had appropriate PEF measurements and follow-up data. Of those patients, 42% (161/385) required at least one operation during study follow-up. The mean PEF preceding operative intervention was 241 L/min (95% confidence interval [CI]: 120-380) corresponding to a predicted PEF of 52%. The mean increase in PEF following a procedure was 111 L/min (95% CI: 96-125 L/min). Interestingly, the magnitude of immediate PEF improvement was not predictive of disease recurrence (hazard ratio [HR] for 100 L/min increase = 0.90, 95% CI: 0.60-1.00). However, recurrence was associated with the magnitude of PEF decline over 90 days (30% vs. 10% decline, HR = 2.2, 95% CI: 1.5-3.0). CONCLUSIONS: We provide normative PEF data on a large iSGS patient cohort. The degree of PEF improvement immediately after surgery was not associated with a longer procedure-free interval. However, a 30% decline in PEF over 90 days was associated with elevated risk of disease recurrence. LEVEL OF EVIDENCE: 2 Laryngoscope, 131:E2841-E2848, 2021.


Assuntos
Laringoscopia/estatística & dados numéricos , Laringoestenose/diagnóstico , Pico do Fluxo Expiratório , Reoperação/estatística & dados numéricos , Adulto , Feminino , Humanos , Laringoestenose/cirurgia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Recidiva , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Inquéritos e Questionários , Resultado do Tratamento
11.
Forensic Sci Med Pathol ; 17(3): 481-485, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34263414

RESUMO

Delayed subglottic stenosis (SGS) is an unusual complication. Here, we report a particular case of delayed SGS. A 17-year-old female suffered extensive injuries including severe neck trauma in a car accident, and complained of dyspnea after 30 days. Tracheal stenosis was observed by fiber optic bronchoscopy, but no specific treatment was administered to the patient. While being transferred to a tertiary hospital 3 days later, the patient fell into deep coma due to hypoxia, and died of hypoxic-ischemic encephalopathy and severe pulmonary infection in the intensive care unit (ICU) 58 days later. Postmortem autopsy and pathological investigation revealed tracheal stenosis 3.0 cm below the vocal cords with a diameter of 0.5 cm, which was caused by a cricoid cartilage fracture, fibrous tissue proliferation and inflammatory cell infiltration. We believed that external forces caused the cricoid fracture and mucosal damage, and after a month of fibrous repair, scar tissue formed the stenosis and caused her death. This report describes a rare condition in which slowly progressive intralaryngeal stenosis formation after external neck trauma could cause asphyxial death in a previously asymptomatic adult.


Assuntos
Laringoestenose , Estenose Traqueal , Adolescente , Asfixia/etiologia , Constrição Patológica , Cartilagem Cricoide , Feminino , Humanos , Laringoestenose/etiologia , Estenose Traqueal/etiologia
13.
Comput Math Methods Med ; 2021: 5517536, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34135990

RESUMO

Objective: The purpose of this study is to explore the effectiveness and safety of Montgomery T-tube placement in treating Cotton-Myer IV subglottic airway atresia after bi-level airway recanalization. Methods: This study is a retrospective study. 11 patients who were treated for IV subglottic airway atresia between January 2017 and January 2019 in the Second Affiliated Hospital of Jiaxing University were involved in this study. The 11 patients all had undergone tracheotomies at our hospital, and they were transferred to the Department of Pulmonary and Critical Care Medicine for Montgomery T-tube placement after bi-level airway recanalization when their subglottic airway was atretic. Patients were observed for their clinical manifestations after placement. The effectiveness of T-tube placement after bi-level airway recanalization was assessed. The incidence of short-term and long-term complications after surgery was assessed. Patients were followed up for 3 to 24 months for evaluating their airway recovery. Results: T-tubes were successfully placed in 11 patients. The atretic airways of all patients were recanalized after treatment. Eight patients got restoration of vocal ability, and 3 patients could only say simple words. None of the patients needed assisted oxygen inhalation. The SpO2 average level was increased from 95 ± 2% before treatment to 97 ± 3% after treatment. Patients had significant relief of cough or sputum, and they had less difficulty in dyspnea. All short- or long-term complications were self-relieved or controlled without further malignant progression after treatment by doctors. The average postoperative extubating time was (14.86 ± 3.62) months. Conclusion: The application of Montgomery T-tube placement in treating Cotton-Myer IV subglottic airway atresia after bi-level airway recanalization is well effective and safe for patients, and it can be promoted in clinical treatment.


Assuntos
Intubação Intratraqueal/instrumentação , Laringoestenose/cirurgia , Adulto , Broncoscópios , Biologia Computacional , Endoscopia , Feminino , Humanos , Intubação Intratraqueal/métodos , Laringoestenose/etiologia , Laringoestenose/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
17.
Laryngoscope ; 131(12): E2880-E2886, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34117778

RESUMO

OBJECTIVES/HYPOTHESIS: Adjuvant medications including proton pump inhibitors (PPI), antibiotics (trimethoprim/sulfamethoxazole [TMP-SMX]), and inhaled corticosteroids (ICS) may be prescribed for patients with idiopathic subglottic stenosis (iSGS). We describe medication use with endoscopic dilation (ED) or endoscopic resection with medical treatment (ERMT) and evaluate impact on outcomes. STUDY DESIGN: International, prospective, 3-year multicenter cohort study of 810 patients with untreated, newly diagnosed, or previously treated iSGS. METHODS: Post hoc secondary analysis of prospectively collected North American Airway Collaborative data on outcomes linked with adjuvant medication utilization. Primary outcome was time to recurrent operation, evaluated using Kaplan-Meier curves and Cox regression analysis. Secondary outcomes of change in peak expiratory flow (PEF) and clinical chronic obstructive pulmonary disease questionnaire (CCQ) score over 12 months were compared. RESULTS: Sixty-one of 129 patients undergoing ED received PPI (47%), and 10/143 patients undergoing ED received ICS (7%). TMP-SMX was used by 87/115 patients (76%) undergoing EMRT. PPI use in the ED group did not affect time to recurrence (hazard ratio [HR] = 1.00, 95% confidence interval [CI]: 0.53-1.88; P = .99) or 12-month change in PEF (L/min) (median [interquartile range], 12.0 [10.7-12.2] vs. 8.7 [-5.1 to 24.9]; P = .59), but was associated with 12-month change in CCQ (-0.05 [-0.97 to 0.75] vs. -0.50 [-1.60 to 0.20]; P = .04). ICS did not affect outcome measures. TMP-SMX use in ERMT did not affect time to recurrence (HR = 0.842, 95% CI: 0.2345-3.023; P = .79), PEF at 12 months (75 [68-89] vs. 81 [68-89]; P = .92), or 12-month change in CCQ (0.20 [-1.05 to 0.47] vs. -0.30 [-1.00 to 0.10]; P = .45). CONCLUSION: There is no standard practice for prescribing adjuvant medications. These data do not support that adjuvant medications prolong time to recurrence or increase PEF. Patients with iSGS and gastroesophageal reflux disease may experience some symptom benefit with PPI. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E2880-E2886, 2021.


Assuntos
Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Dilatação/métodos , Laringoscopia/métodos , Laringoestenose/terapia , Inibidores da Bomba de Prótons/uso terapêutico , Adulto , Terapia Combinada , Dilatação/estatística & dados numéricos , Feminino , Humanos , Laringoscopia/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recidiva , Fatores de Tempo , Resultado do Tratamento
18.
Am J Pathol ; 191(8): 1412-1430, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34111429

RESUMO

Idiopathic subglottic stenosis (iSGS) is a progressive fibrotic disease characterized by life-threatening airway narrowing. Although the molecular underpinnings are unknown, previous reports showing that subglottic serial intralesional steroid injections (SILSIs) improve clinical outcomes suggest a steroid-sensitive pathway in iSGS. Herein, a prospective study was conducted to determine the changes in profibrotic markers during SILSI to identify steroid-sensitive profibrotic drivers. Seven newly diagnosed patients with iSGS were recruited for SILSI. Subglottic biopsies before and after SILSI treatments were evaluated for histologic and molecular markers by confocal microscopy and RT-qPCR. At baseline, iSGS subglottises contained abundant vimentin-positive/α-smooth muscle actin-negative fibroblasts, intermingled with a matrix of fibronectin and types I and VI collagen. Transforming growth factor (TGF)-ß1 was up-regulated primarily in glandular epithelium. Cellular communication network factor 2 (CCN2) was mainly up-regulated in stromal fibroblasts surrounding TGF-ß1-positive glandular structures. SILSI improved iSGS by reducing fibroblast infiltration and increasing matrix remodeling. Mechanistically, SILSI counteracted the effects of TGF-ß1 by inducing matrix metalloprotease 9 (MMP9) expression while repressing CCN2 expression, without affecting TGFß1 levels. Treatment of primary iSGS-derived fibroblasts with TGF-ß1 recapitulated aspects of the disease in vivo, demonstrating that the induction in CCN2 and repression of MMP9 are caused by changes in histone acetylation induced by TGF-ß1. Triamcinolone counteracted the coregulation of these genes by impairing SMAD2/3 binding to promoter regions, and not through histone acetylation. In conclusion, this study shows that SILSI counteracts a dysregulated TGF-ß1/CCN2/MMP9 axis involved in iSGS development.


Assuntos
Anti-Inflamatórios/uso terapêutico , Laringoestenose/tratamento farmacológico , Transdução de Sinais/efeitos dos fármacos , Triancinolona/uso terapêutico , Fator de Crescimento do Tecido Conjuntivo/efeitos dos fármacos , Fator de Crescimento do Tecido Conjuntivo/metabolismo , Regulação para Baixo , Humanos , Injeções Intralesionais , Laringoestenose/metabolismo , Laringoestenose/patologia , Metaloproteinase 9 da Matriz/efeitos dos fármacos , Metaloproteinase 9 da Matriz/metabolismo , Fator de Crescimento Transformador beta1/efeitos dos fármacos , Fator de Crescimento Transformador beta1/metabolismo
19.
Semin Pediatr Surg ; 30(3): 151055, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34172206

RESUMO

Congenital airway anomalies (CAA) include a variety of conditions that cause respiratory distress in neonates and infants. These malformations occur at various anatomic levels and manifest in a wide spectrum of airway symptoms, with presentation significantly influenced by the level at which obstruction occurs as well as by the severity of obstruction. The prevalence of congenital airway malformations has been estimated to range between 0.2 and 1 in 10,000 live births. The most frequent CAA are laryngomalacia, bilateral vocal cord paralysis, subglottic stenosis, laryngeal webs, subglottic hemangioma, tracheomalacia, congenital tracheal stenosis, laryngotracheal cleft, and tracheal agenesis.


Assuntos
Doenças da Laringe , Laringomalácia , Laringoestenose , Laringe , Paralisia das Pregas Vocais , Humanos , Lactente , Recém-Nascido , Laringoestenose/diagnóstico , Laringoestenose/etiologia
20.
Semin Pediatr Surg ; 30(3): 151052, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34172219

RESUMO

Laryngeal stenosis is certainly one of the most severe complications of airway intubation in children, eventually leading to tracheostomy and sometimes to additional surgical procedures. Primary prophylaxis through modification of its risk factors and secondary prophylaxis through the management of post-extubation laryngeal acute lesions seem to be key to avoidance of this fearful complication. The present article addresses known risk factors for the development of laryngeal acute lesions with emphasis on sedation level and intubation time. It also discusses available classification systems proposed in medical literature, especially the Classification of Acute Laryngeal Injuries (CALI) conceived by our research group, and its positive predictive value for the development of chronic lesions. Finally, debate focuses on treatment of each individual lesion. Despite excellent results observed with endoscopic methods for treating these lesions, there is still doubts pending over their management, and there is need for further studies to define adequate treatment for each patient and for each type of lesion.


Assuntos
Doenças da Laringe , Laringoestenose , Laringe , Criança , Humanos , Intubação Intratraqueal/efeitos adversos , Laringoestenose/diagnóstico , Laringoestenose/etiologia , Laringoestenose/terapia , Fatores de Risco
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