Contemporary surgical strategies for pediatric laryngotracheal stenosis: a comprehensive review

BackgroundPediatric laryngotracheal stenosis (LTS) presents a complex and heterogeneous clinical challenge, requiring individualized surgical approaches to restore airway patency and function. Depending on stenosis severity, anatomical site, and comorbidities, a range of surgical techniques—includin...

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Main Authors: Hanne Oscé, Jeroen Meulemans, Greet Hens
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1634634/full
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author Hanne Oscé
Jeroen Meulemans
Greet Hens
author_facet Hanne Oscé
Jeroen Meulemans
Greet Hens
author_sort Hanne Oscé
collection DOAJ
description BackgroundPediatric laryngotracheal stenosis (LTS) presents a complex and heterogeneous clinical challenge, requiring individualized surgical approaches to restore airway patency and function. Depending on stenosis severity, anatomical site, and comorbidities, a range of surgical techniques—including laryngotracheal reconstruction (LTR), partial cricotracheal resection (PCTR), extended PCTR, and endoscopic posterior cricoid split with rib grafting (EPCS/RG)—may be employed.MethodsThis narrative review synthesizes current surgical strategies for pediatric LTS based on current literature, highlighting their indications, operative considerations, and reported outcomes. Key factors affecting surgical success, such as patient selection and perioperative management, are discussed.ResultsSingle-stage LTR is favored in healthy children with moderate SGS, while PCTR offers superior outcomes in severe or recurrent cases. EPCS/RG represents a minimally invasive alternative for LTR in selected cases with posterior glottic stenosis. Decannulation rates generally exceed 85% in carefully selected patients, though voice and swallowing outcomes vary by technique.ConclusionOptimal management of pediatric LTS requires a multidisciplinary, tailored approach. Continued focus on long-term functional outcomes, technical innovations, and multicenter collaboration will further improve patient care.
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spelling doaj-art-1c7cf54a833d4a4a97ad09943303cfdf2025-08-26T05:27:53ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-08-011310.3389/fped.2025.16346341634634Contemporary surgical strategies for pediatric laryngotracheal stenosis: a comprehensive reviewHanne OscéJeroen MeulemansGreet HensBackgroundPediatric laryngotracheal stenosis (LTS) presents a complex and heterogeneous clinical challenge, requiring individualized surgical approaches to restore airway patency and function. Depending on stenosis severity, anatomical site, and comorbidities, a range of surgical techniques—including laryngotracheal reconstruction (LTR), partial cricotracheal resection (PCTR), extended PCTR, and endoscopic posterior cricoid split with rib grafting (EPCS/RG)—may be employed.MethodsThis narrative review synthesizes current surgical strategies for pediatric LTS based on current literature, highlighting their indications, operative considerations, and reported outcomes. Key factors affecting surgical success, such as patient selection and perioperative management, are discussed.ResultsSingle-stage LTR is favored in healthy children with moderate SGS, while PCTR offers superior outcomes in severe or recurrent cases. EPCS/RG represents a minimally invasive alternative for LTR in selected cases with posterior glottic stenosis. Decannulation rates generally exceed 85% in carefully selected patients, though voice and swallowing outcomes vary by technique.ConclusionOptimal management of pediatric LTS requires a multidisciplinary, tailored approach. Continued focus on long-term functional outcomes, technical innovations, and multicenter collaboration will further improve patient care.https://www.frontiersin.org/articles/10.3389/fped.2025.1634634/fullpediatric airwaylaryngotracheal stenosislaryngotracheal reconstructioncricotracheal resectionairway surgerysubglottic stenosis
spellingShingle Hanne Oscé
Jeroen Meulemans
Greet Hens
Contemporary surgical strategies for pediatric laryngotracheal stenosis: a comprehensive review
Frontiers in Pediatrics
pediatric airway
laryngotracheal stenosis
laryngotracheal reconstruction
cricotracheal resection
airway surgery
subglottic stenosis
title Contemporary surgical strategies for pediatric laryngotracheal stenosis: a comprehensive review
title_full Contemporary surgical strategies for pediatric laryngotracheal stenosis: a comprehensive review
title_fullStr Contemporary surgical strategies for pediatric laryngotracheal stenosis: a comprehensive review
title_full_unstemmed Contemporary surgical strategies for pediatric laryngotracheal stenosis: a comprehensive review
title_short Contemporary surgical strategies for pediatric laryngotracheal stenosis: a comprehensive review
title_sort contemporary surgical strategies for pediatric laryngotracheal stenosis a comprehensive review
topic pediatric airway
laryngotracheal stenosis
laryngotracheal reconstruction
cricotracheal resection
airway surgery
subglottic stenosis
url https://www.frontiersin.org/articles/10.3389/fped.2025.1634634/full
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