[Recurrent respiratory distress and idiopathic subglottic stenosis: what treatment?].

Abstract

Background: Idiopathic subglottic stenosis is a rare cause of acute respiratory distress, that is difficult to treat (corticosteroids, tracheotomy).

Case report: A nine-year-old boy presented with acute respiratory distress due to tracheal stenosis. The symptoms recurred after the endotracheal inflammatory membranes had been removed with forceps, despite 6-months of degressive corticotherapy. Absence of other causes of tracheal stenosis and biopsies led to diagnosis of idiopathic subglottic stenosis. The patient was treated by CO2 laser followed by degressive corticotherapy. The respiratory distress recurred within 3 months of discontinuing corticosteroids, requiring two further CO2 laser treatments. The patient became corticodependent.

Conclusions: CO2 laser is an effective, wise alternative treatment of acute respiratory distress due to idiopathic subglottic stenosis that can be repeated if necessary.