International journal of pediatric otorhinolaryngology · 2025
Pediatric idiopathic tracheal stenosis - A scoping review of the literature and case series of an unclassified pathology.
СтатьяScoping ReviewКлинический случайНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Eyassu Daniel G, Lee Natasha S, Ali Hawa M, Messick Cody L, Green Katerina J, Wiedermann Joshua P
Аннотация
INTRODUCTION: Pediatric tracheal stenosis is commonly caused by congenital or iatrogenic etiologies. This study introduces pediatric idiopathic tracheal stenosis (PITS) to refer to a cohort of pediatric patients with idiopathic multilevel large airway stenosis. This study proposes a novel treatment strategy trialed in four patients and reviews the literature for similar disease patterns.
METHODS: A literature search was conducted including studies of patients under 18-years-old with tracheal stenosis of unknown etiology, yielding 6 included studies. We contribute four patients treated with CO2 laser wedge excision of tracheal scar, mitomycin C application, and triamcinolone injection followed by postoperative triple therapy with omeprazole, trimethoprim-sulfamethoxazole and inhaled fluticasone.
RESULTS: A review of literature found seven similar cases, with high recurrence rates and no consensus on management strategies. In our case series, four pediatric patients (ages 9-14) with refractory idiopathic tracheal stenosis presented with chronic respiratory symptoms. All patients had multilevel spiral tracheal scarring with involvement of the carina and eosinophils in mucosal biopsies. Work-ups for infectious, immune, or genetic causes were uniformly negative. Initial treatments, including medical therapy and balloon dilations, failed. Definitive management with our proposed regimen led to sustained symptom remission in all cases (6 months-2.75 years).
CONCLUSIONS: PITS is sparsely described in the literature with no existing treatment consensus. We propose a novel treatment regimen that demonstrated remission of disease in this limited case series. The exploration of treatment regimens is a priority in furthering the outcomes for pediatric patients with this unique and rare airway disease.
METHODS: A literature search was conducted including studies of patients under 18-years-old with tracheal stenosis of unknown etiology, yielding 6 included studies. We contribute four patients treated with CO2 laser wedge excision of tracheal scar, mitomycin C application, and triamcinolone injection followed by postoperative triple therapy with omeprazole, trimethoprim-sulfamethoxazole and inhaled fluticasone.
RESULTS: A review of literature found seven similar cases, with high recurrence rates and no consensus on management strategies. In our case series, four pediatric patients (ages 9-14) with refractory idiopathic tracheal stenosis presented with chronic respiratory symptoms. All patients had multilevel spiral tracheal scarring with involvement of the carina and eosinophils in mucosal biopsies. Work-ups for infectious, immune, or genetic causes were uniformly negative. Initial treatments, including medical therapy and balloon dilations, failed. Definitive management with our proposed regimen led to sustained symptom remission in all cases (6 months-2.75 years).
CONCLUSIONS: PITS is sparsely described in the literature with no existing treatment consensus. We propose a novel treatment regimen that demonstrated remission of disease in this limited case series. The exploration of treatment regimens is a priority in furthering the outcomes for pediatric patients with this unique and rare airway disease.