Chapter 28 - Anesthesia for the management of subglottic stenosis and tracheal resection

Summary

Subglottic stenosis can be divided into two broad categories: congenital and acquired. Congenital causes of subglottic stenosis overwhelmingly occur in utero and result from malformation of the cricoid cartilage. While subglottic stenosis can affect all age groups, most experts differentiate the disease and its process based on a pediatric or adult presentation. The airway stents currently used are designed for use in benign airway disease, preoperatively to restore airway patency prior to surgical treatment, and for malignant airway disease prior to chemoradiation, with malignancy being the most common indication for their use. During the open airway portion of tracheal resection, gas exchange can be performed in one of four ways: (1) jet ventilation, (2) distal tracheal intubation and intermittent positive pressure ventilation, (3) spontaneous ventilation, and (4) cardiopulmonary bypass. Postoperatively these patients are typically admitted to the intensive care unit (ICU) for postoperative management.