Infants with laryngotracheal anomalies are clinically manifested as stridor or noisy breathing, choking, hoarseness, feeding difficulties, and cyanotic spells, followed by developmental and growth retardation and other health issues; in severe cases, patients may present with severe dyspnea, which is associated with high mortality. A timely diagnosis as well as appropriate strategy for laryngotracheal anomalies is still challenging for pediatric otolaryngologists. This consensus statement, evolved from expert opinion by the members of the Pediatric Otorhinolaryngology Professional Committee of the Pediatrician Branch of the Chinese Medical Doctor Association, provides comprehensive recommendations and standardized guidance for otolaryngologists who manage infants and young children with laryngotracheal anomalies in evaluation and treatment based on symptomatology, physical and laboratory examinations.
摘要: 婴幼儿喉气道结构异常的患者在临床上表现为喘鸣、呛咳、声音嘶哑、喂养困难、间歇性青紫，以及部分患儿呼吸道梗阻导致重度的呼吸困难，甚至死亡，随之出现生长发育缓慢等健康问题，如何早期诊断与评估是儿童耳鼻喉科医生在临床上面对的极为棘手的问题。中国医师协会儿科医师分会儿童耳鼻咽喉专业委员会联合全国多家国家或区域儿童医疗中心讨论拟定评估共识，从症状学、客观检查等方面制定出了儿童气道结构异常的评估诊断方案，为临床规范化诊疗提供指导性意见。.

Individuals reporting episodes of breathing problems caused by re-occurring variable airflow obstructions in the larynx have been described in an increasing number of publications, with more than 40 different terms being used without consensus on definitions. This lack of an international consensus on nomenclature is a serious obstacle for the development of the area, as knowledge from different centres cannot be matched, pooled or readily utilised by others. Thus, an international Task Force has been created, led by the European Respiratory Society/European Laryngological Society/American College of Chest Physicians. This review describes the methods used to reach an international consensus on the subject and the resulting nomenclature, the 2013 international consensus conference nomenclature.

Adult and pediatric laryngotracheal stenoses (LTS) comprise a wide array of various conditions that require precise preoperative assessment and classification to improve comparison of different therapeutic modalities in a matched series of patients. This consensus paper of the European Laryngological Society proposes a five-step endoscopic airway assessment and a standardized reporting system to better differentiate fresh, incipient from mature, cicatricial LTSs, simple one-level from complex multilevel LTSs and finally \"healthy\" from \"severely morbid\" patients. The proposed scoring system, which integrates all of these parameters, may be used to help define different groups of LTS patients, choose the best treatment modality for each individual patient and assess distinct post-treatment outcomes accordingly.

Surgical reconstruction of paediatric laryngotracheal stenosis (LTS) has only been developed over the last 30 years, but during that period great advances have been made, and the operation is now very much tailored to the needs of the individual patient. Closed (endoscopic) techniques have a very limited place in the correction of LTS. Of the open surgical techniques, laryngotracheal reconstruction (LTR) with cartilage grafting can precisely correct grade II and mild grade III stenosis with minimal morbidity and high decannulation rates. Partial cricotracheal resection (PCTR) can deliver high success rates for more severe stenoses, but it is a more complex procedure. Because LTR is more straightforward, it tends to be preferred for grade II and mild grade III stenosis. For a suitably experienced surgeon, PCTR is the preferred option for grade IV and severe grade III stenosis, especially where there is a clear margin between the stenosis and the vocal cords. The best chance for the patient lies in the first operation: this means that the surgeon managing the problem must be fully trained in paediatric airway endoscopy and laryngotracheal surgery, since inappropriate initial management of LTS may lead to permanent intractable sequelae.

OBJECTIVE: To review all patients undergoing single-stage laryngotracheal reconstruction and to determine guidelines to predict successful outcomes and prevent the necessity of tracheotomy following laryngotracheal reconstruction.
METHODS: Chart review.
METHODS: Tertiary care children\'s hospital.
METHODS: A retrospective chart review was performed at our institution involving all patients who underwent single-stage laryngotracheal reconstruction from 1993 through 1996. A total of 28 patients were reviewed.
RESULTS: Based on this chart review, a statistically higher incidence of extubation complications (P = .045), ie, bleeding, reintubation, or subcutaneous emphysema, occurred in children who weighed less than 4 kg. Although not statistically significant (P>.99), the relative risks of failure, defined as tracheotomy dependent or significant airway compromise following single-stage laryngotracheal reconstruction, were 3.43 if the child\'s weight was less than 4 kg at the time of surgery and 2.31 if the gestational age was less than 30 weeks at the time of surgery. Length of time for intubation did not appear to have any effect on outcome.
CONCLUSIONS: Patients\' gestational age and weight at the time of surgery appear to have the most impact on successful outcome. Children weighing more than 4 kg and those with gestational age of greater than 30 weeks appear to have a greater chance at successful extubation and eventual patent airway. Duration of intubation following single-stage laryngotracheal reconstruction does not appear to affect outcome.