Publication: Konjenital ve edinsel subglottik stenoz
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Date
2022-05-01
Authors
Authors
Kılıç Başkan A.
Kılınç Sakallı A. A.
Çalım Ö. F.
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Türkiye Klinikleri Yayınevi
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Abstract
Subglottik stenoz (SGS), çocukluk çağında kronik üst solunum yolu obstrüksiyonunun en sık nedenlerinden biridir. Konjenital veya edinsel nedenlerle oluşabilir. En sık endotrakeal tüp veya trakeostominin oluşturduğu hasara bağlı anormal yara iyileşmesi sonucu oluşmaktadır. Bu nedenle; tanısında ayrıntılı anamnez önemlidir. Risk faktörleri varlığında SGS araştırılmalıdır. Stridor en sık semptomdur ancak diğer solunum sistemi bulguları ile de karşımıza çıkabilir. Tanıda öncelikle laringoskop ile değerlendirilme önerilmektedir. Laringoskopi ile tanı koyulamadığında bronkoskopi ikinci basamak tanı yöntemi olarak tercih edilmelidir. Darlığın şiddetine göre farklı tedavi protokolleri uygulanır. Hafif darlığı olan vakaların çoğunda konservatif yaklaşım yeterli iken, orta ve şiddetli subglottik stenoz tedavisinde genellikle cerrahi gereklidir. Pediatrik hastalarda subglottik stenozun (SGS) değerlendirilmesi ve yönetimi karmaşık ve teknik olarak zor olduğundan uzmanlaşmış bir ekip ile multidisipliner yaklaşım gerektirir.
Subglottic stenosis (SGS) is one of the most common causes of chronic upper airway obstruction in childhood. It can occur due to congenital or acquired reasons. It most commonly occurs as a result of abnormal wound healing due to damage to the endotracheal tube or tracheostomy. Therefore, detailed anamnesis is important in the diagnosis. In the presence of risk factors, SGS should be investigated. Stridor is the most common symptom, but it may also present with other respiratory system findings. In the diagnosis, it is recommended to evaluate with laryngoscope first. When the diagnosis cannot be made by laryngoscopy, bronchoscopy should be preferred as a second-line diagnostic method. Different treatment protocols are applied according to the severity of the stenosis. While the conservative approach is sufficient in most cases with mild stenosis, surgery is usually required for the treatment of moderate to severe subglottic stenosis. The assessment and management of subglottic stenosis (SGS) in pediatric patients is complex and technically challenging, requiring a multidisciplinary approach with a specialized team.
Subglottic stenosis (SGS) is one of the most common causes of chronic upper airway obstruction in childhood. It can occur due to congenital or acquired reasons. It most commonly occurs as a result of abnormal wound healing due to damage to the endotracheal tube or tracheostomy. Therefore, detailed anamnesis is important in the diagnosis. In the presence of risk factors, SGS should be investigated. Stridor is the most common symptom, but it may also present with other respiratory system findings. In the diagnosis, it is recommended to evaluate with laryngoscope first. When the diagnosis cannot be made by laryngoscopy, bronchoscopy should be preferred as a second-line diagnostic method. Different treatment protocols are applied according to the severity of the stenosis. While the conservative approach is sufficient in most cases with mild stenosis, surgery is usually required for the treatment of moderate to severe subglottic stenosis. The assessment and management of subglottic stenosis (SGS) in pediatric patients is complex and technically challenging, requiring a multidisciplinary approach with a specialized team.
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Keywords
Tıp, Cerrahi Tıp Bilimleri, Kulak Burun Boğaz, Sağlık Bilimleri, Medicine, Surgery Medicine Sciences, Otolaryngology, Health Sciences, Klinik Tıp (MED), Klinik Tıp, CERRAHİ, KULAK BURUN BOĞAZ, Clinical Medicine (MED), CLINICAL MEDICINE, SURGERY, OTORHINOLARYNGOLOGY, Konuşma ve İşitme, Cerrahi, Speech and Hearing, Surgery, Otorhinolaryngology
Citation
Kılıç Başkan A., Kılınç Sakallı A. A., Çalım Ö. F., Konjenital ve edinsel subglottik stenoz, "Çocuklarda Enfeksiyon Dışı Hava Yolu Hastalıkları", Erkan Çakır, Editör, Türkiye Klinikleri Yayınevi, Ankara, ss.59-63, 2022