Subglottic stenosis and Down syndrome.

The possibility of subglottic stenosis in children with Down syndrome is well recognized. Nevertheless, this anomaly and its effect on laryngeal and respiratory function are frequently overlooked. When subglottic stenosis is present in a child with Down syndrome, the standard intubation technique may require modification. In these children, an endotracheal tube of a size appropriate to the patient's age may be too tight in the subglottic area. By aggravating a previously asymptomatic subglottic stenosis, long-term endotracheal intubation in this type of patient may be more likely to lead to a clinically significant subglottic stenosis. In our experience, subglottic stenosis in children with Down syndrome is more difficult to repair and is associated with a lower success rate of decannulation. Additionally, it is important in the management of these children not to create an even more severe subglottic stenosis.