Non-operative management of congenital tracheal stenosis: criteria by computed tomography
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In brief
In brief
Study of 28 congenital tracheal stenosis cases establishes CT-based criteria for conservative management: tracheal narrowest diameter ≥40% of age-normal predicts successful non-operative outcomes. Findings provide objective imaging thresholds to guide surgical versus observational approaches in pediatric airway stenosis.
Written by the GCMD Library team from the article.
Abstract
Objectives
Whether to perform surgical or conservative treatment for congenital tracheal stenosis (CTS) is controversial. Thus, the computed tomography (CT) criteria for conservative treatment of CTS were investigated.
Methods
From 2005 to 2017, 28 CTS cases were included. The operative cases and preoperative death cases constituted the required intervention group (group I), and the non-operative surviving cases constituted the observation group (group O). The diameter of the tracheal narrowest part (DTNP) on CT was evaluated as a criterion for non-operative follow-up.
Results
Chest CT was performed 19 times in 19 group I cases and 18 times in 9 group O cases. The median age of the patients that underwent CT scan examinations was 3.4 months (range 0–25 months) in group I and 22 months (range 0–60 months) in group O. The cut-off values of the non-operative criteria were 40.8% (AUC: 0.82, p < .01) normal for age of the trachea’s narrowest part, and 41.6% normal for body weight (AUC: 0.92, p < .01), respectively.
Conclusions
DTNP is 40% and more of the normal diameter appears necessary for non-surgical management. The present study suggests that the criteria for conservative management of CTS are that the DTNP is not less than 40% of the normal tracheal diameter, with a few symptoms.