Effects of post-intubation laryngeal stenosis treatment depending on the grade of stenosis

Introduction. Laryngeal stenosis as a complication of prolonged endotracheal intubation is a current problem in paediatric laryngology because of the growing population of prematurely born children. The aim of our study was to analyse the cases of post-intubation laryngeal stenosis in terms of the frequency and severity of the complications, as well as to evaluate the effects of endoscopic treatment. Material and methods. The study included 92 children treated for laryngeal stenosis. The analysis involved the comparison of the children in terms of the degree of subglottic stenosis and its effect on treatment. Laryngeal stenosis was treated with endoscopy, which was performed under general anaesthesia. Results. In the group of children with laryngeal stenosis, supraglottic stenosis was found in 9.78% of children, grade I subglottic stenosis occurred in 10.87% of children, grade II in 41.3% of children, grade III in 18.48% of children, and grade IV in 19.57% of children. Of 92 patients, only 41 were full-term (44.57%) and 51 (55.43%) were premature. In the treated group, full recovery and a reduction of laryngeal stenosis were noted in 44 (48%) and 38 children (41%), respectively, while the failure of treatment was reported in 10 patients, representing 11% of the population. In the group of premature infants, 20 children (39.22%) were cured, the condition improved in 22 cases (43.14%) and treatment failed in 9 patients (17.65%). Of 41 full-term children, full recovery was observed in 24 (58.54%), improvement in 16 (39.02%) and failure in one case (2.44%). There was also an increase in the risk of treatment failure in advanced stenosis of grade III and IV according to Cotton–Myer. Conclusions. Laryngeal stenosis is a common problem in premature infants. Endoscopic treatment is an effective surgical method. Failure of endoscopic treatment is related to the degree of stenosis. Grades III and IV are more difficult to treat. Keywords