Nelson Textbook of Pediatrics 22nd Edition | Second most common cause of stridor in neonates. Congenital (elliptical cricoid) vs acquired (prolonged intubation - 90% of acquired). Clinical: biphasic stridor, recurrent croup, failed extubation. Diagnosis: bronchoscopy (Myer-Cotton grading I-IV). Treatment: mild observe, moderate-severe laryngotracheal reconstruction (anterior cricoid split, cartilage graft) or cricotracheal resection. Prevention: use age-appropriate ETT with air leak, treat GERD, minimize intubation duration.
🌐 paeds.online — Pakistan's Pediatric Platform| Grade | % Stenosis | Management |
|---|---|---|
| Grade I | 0-50% | Observation, treat GERD, serial bronchoscopy. Often asymptomatic or mild stridor. May not require intervention. |
| Grade II | 51-70% | Endoscopic dilation or laser (if soft stenosis). May require reconstruction if symptomatic (stridor at rest, FTT). |
| Grade III | 71-99% | Laryngotracheal reconstruction (LTR) with anterior cricoid split or cartilage graft. May require tracheostomy. |
| Grade IV | 100% (no lumen) | Cricotracheal resection (CTR) or LTR with grafting. Tracheostomy almost always required. |