Tracheal stenosis in children
A congenital tracheal stenosis is very rare. However, if it occurs, it is usually associated with further malformations and malformations in the esophagus, other parts of the respiratory tract and the child’s skeleton. Depending on the extent and location of the stenosis, the severity of the symptoms varies.
Stenoses that cover a rather short distance can be operated on. However, if the congenital stenosis constricts the trachea (windpipe) over a longer distance, tracheoplasty can be performed. Normally, horseshoe-shaped cartilage braces surround the trachea from ventral (front).
From dorsal (back), the trachea is separated from the esophagus by a connective tissue membrane. In children with a congenital tracheal narrowing, some of these cartilage clips are very often malformed and enclose the entire trachea (windpipe) as a ring of cartilage. As a result, the trachea is severely constricted at these points.
In a slide tracheoplasty (“slip”), the trachea is cut horizontally in the middle of the stenosis: it is now divided into two parts, upper and lower. Next, the sections of the trachea above and below the stenosis (narrowing) are cut open. Above the stenosis it is opened at the front and below the stenosis it is opened at the back: you can now look into the trachea from the front in the upper part and from the back in the lower part.
The two parts are now opened so that part above the stenosis has only a front wall and the part below the stenosis only a rear wall. In the next step, these two tracheal parts are now pushed together so that the front wall and the rear wall lie on top of each other and can be sewn together. The fact that the trachea is now somewhat shorter is no problem.
But the lumen (diameter) of the trachea is now considerably larger, because the cartilage clasps are bent up like a horseshoe and now two former small rings form a single large ring. Depending on whether further malformations are diagnosed in the child, further operations on the heart and lungs can be performed during the course of the operation.
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