Severity Scoring for Pediatric Patients with Pharyngeal Stenosis Requiring Tracheostomy

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  • Takada Natsuki
    Department of Otolaryngology, National Center for Child Health and Development Department of Otolaryngology, Gifu Prefectural General Medical Center
  • Hara Mariko
    Department of Otolaryngology, National Center for Child Health and Development
  • Wada Yuka
    Department of Neonatology, National Center for Child Health and Development
  • Watabe Takahisa
    Department of Otolaryngology, National Center for Child Health and Development Department of Otolaryngology, Tokyo Metropolitan Ohtsuka Hospital
  • Takahashi Nozomi
    Department of Otolaryngology, National Center for Child Health and Development Department of Otolaryngology-Head and Neck Surgery, Sapporo Medical University
  • Ogawa Takenori
    Department of Otolaryngology-Head and Neck Surgery, Gifu University Hospital
  • Morimoto Noriko
    Department of Otolaryngology, National Center for Child Health and Development

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Other Title
  • 気管切開を要した小児咽頭狭窄症例に対する重症度スコアリング化の試み
  • キカン セッカイ オ ヨウシタ ショウニ イントウ キョウサク ショウレイ ニ タイスル ジュウショウド スコアリングカ ノ ココロミ

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Abstract

<p>The symptoms of mild cases of upper airway obstruction due to pharyngeal stenosis may improve with conservative treatment, such as nasal airways and noninvasive positive pressure ventilation ; however, tracheostomy is required in severe cases. As there is no severity classification for pharyngeal stenosis, objectively determining its severity is difficult. Therefore, to clarify the factors that cause severe symptoms and influence prognosis, we retrospectively examined the causes, prognosis, and outcome of 17 cases of pharyngeal stenosis that required tracheostomy at our hospital. The scores were assigned as follows : 1 point was given for nasal, nasopharyngeal, or oropharyngeal stenosis ; 2 points for laryngomalacia, tracheomalacia, central apnea, or neurological disease ; and 3 points for pulmonary disease or dysphagia. The scores of patients who were successfully decannulated were 1-4, whereas those of patients who could not be decannulated were 4-13. Notably, the scores of the patients who were decannulated were significantly lower than those of the patients who were not decannulated. Patients with scores of ≥8 tended to require ventilator management. Moreover, dysphagia significantly prevented decannulation. This scoring system may help determine the treatment strategy for respiratory disorders in patients with pharyngeal stenosis.</p>

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