Virtual Pediatric Hospital: ElectricAirway: Upper Airway Problems in Children
ElectricAirway: Upper Airway Problems in Children: Croup Syndromes
Answer to 17
Donna M. Santer, M.D., Michael P. D'Alessandro, M.D.
Peer Review Status: Externally Peer Reviewed by Lauren D Holinger, MD, Robert J. Winter, MD and the AMA
The answer is D. Acquired subglottic stenosis is caused by trauma to the subglottic structures secondary to endotracheal intubation, foreign body, infection, or chemical irritation such as the lye ingestion in this child. The respiratory epithelium is very susceptible to irritation, and, if it persists, the original edema and hyperemia progress to ulceration and local infection with growth of granulation tissue (Picture C). Bronchoscopy shows more severe stenosis than is found in congenital subglottic stenosis. Circumferential stenosis with an associated web (Picture B) or band is often noted. Vocal cord paralysis may also be seen (Video B).
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