Progress on Diagnosis and Treatment of Congenital Tracheal Stenosis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

DUZhou , LIUJin-long ,  LIUJin-fen

Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University, Shanghai 200127, P. R. China;

Corresponding author：

LIUJin-fen, Email: liujinfen2002@126.com

Keywords：

Congenital trachea stenosis; Computational fluid dynamics; Tissue-engineering trachea; 3D printing

DOI：

10.7507/1007-4848.20160039

Video：

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Congenital tracheal stenosis (CTS) is a rare but potentially life-threatening disease which results in congnital airway lesion. CTS is often associated with cardiovascular anomalies and presented with a wide spectrum of symptoms. CTS has challenged pediatric surgeons for decades. Various classic approaches and new techniques, including computational fluid dynamics, tissue-engineering trachea, and 3D printing have been proposed for diagnosis and treatment of CTS. This review provides a snapshot of the main progress of diagnosis and treatment of CTS.

Citation： DUZhou, LIUJin-long, LIUJin-fen. Progress on Diagnosis and Treatment of Congenital Tracheal Stenosis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(2): 178-182. doi: 10.7507/1007-4848.20160039 Copy

1.	Cantrell JR, Guild HG. Congenital stenosis of the trachea. Am J Surg, 1964, 108(8): 297-305.
2.	Wolman IJ. Congenital stenosis of the trachea. Am J Dis Child, 1941, 61:1263-1271.
3.	徐志伟, 王顺民, 杜欣为, 等.小儿先天性心脏病伴气管狭窄的外科处理.中华外科杂志, 2014, 52(2): 127-130.
4.	Anton-Pacheco JL, Cano I, Garcia A, et al. Patterns of management of congenital tracheal stenosis. J Pediatr Surg, 2003, 38(10): 1452-1458.
5.	Cotton RT. Pediatric laryngotracheal stenosis. J Pediatr Surg, 1984, 19(6): 699-704.
6.	Freitag L, Ernst A, Unger M, et al. A proposed classification system of central airway stenosis. Eur Respir J, 2007, 30(1): 7-12.
7.	Anand VK, Alemar G, Warren ET. Surgical considerations in tracheal stenosis. Laryngoscope, 1992, 102(3): 237-243.
8.	Myer CR, O'Connor DM, Cotton RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol, 1994, 103(4 Pt 1): 319-323.
9.	Speggiorin S, Torre M, Roebuck DJ, et al. A new morphologic classification of congenital tracheobronchial stenosis. Ann Thorac Surg, 2012, 93(3): 958-961.
10.	Herrera P, Caldarone C, Forte V, et al. The current state of congenital tracheal stenosis. Pediatr Surg Int, 2007, 23(11): 1033-1044.
11.	Hoppe H, Dinkel HP, Walder B, et al. Grading airway stenosis down to the segmental level using virtual bronchoscopy. Chest, 2004, 125(2): 704-711.
12.	Chiu PP, Kim PC. Prognostic factors in the surgical treatment of congenital tracheal stenosis: a multicenter analysis of the literature. J Pediatr Surg, 2006, 41(1): 221-225.
13.	Harrison MR, Heldt GP, Brasch RC, et al. Resection of distal tracheal stenosis in a baby with agenesis of the lung. J Pediatr Surg, 1980, 15(6): 938-943.
14.	Kleinhaus S, Winslow PR, Sheran M, et al. Evolution of individua-lized management of tracheal obstruction. J Pediatr Surg, 1978, 13(6D): 669-676.
15.	Benjamin B, Pitkin J, Cohen D. Congenital tracheal stenosis. Ann Otol Rhinol Laryngol, 1981, 90(4 Pt 1): 364-371.
16.	Grillo HC, Zannini P. Management of obstructive tracheal disease in children. J Pediatr Surg, 1984, 19(4): 414-416.
17.	Nakayama DK, Harrison MR, De Lorimier AA, et al. Reconstructive surgery for obstructing lesions of the intrathoracic trachea in infants and small children. J Pediatr Surg, 1982, 17(6): 854-868.
18.	Mansfield PB. Tracheal resection in infancy. J Pediatr Surg, 1980, 15(1): 79-81.
19.	Anton-Pacheco JL, Cano I, Comas J, et al. Management of congenital tracheal stenosis in infancy. Eur J Cardiothorac Surg, 2006, 29(6): 991-996.
20.	Kimura K, Mukohara N, Tsugawa C, et al. Tracheoplasty for conge-nital stenosis of the entire trachea. J Pediatr Surg, 1982, 17(6): 869-871.
21.	Idriss FS, Deleon SY, Ilbawi MN, et al. Tracheoplasty with pericardial patch for extensive tracheal stenosis in infants and children. J Thorac Cardiovasc Surg, 1984, 88(4): 527-536.
22.	Dunham ME, Holinger LD, Backer CL, et al. Management of severe congenital tracheal stenosis. Ann Otol Rhinol Laryngol, 1994, 103(5 Pt 1): 351-356.
23.	Cohen RC, Filler RM, Konuma K, et al. A new model of tracheal stenosis and its repair with free periosteal grafts. J Thorac Cardiovasc Surg, 1986, 92(2): 296-304.
24.	Ein SH, Friedberg J, Williams WG, et al. Tracheoplasty--a new operation for complete congenital tracheal stenosis. J Pediatr Surg, 1982, 17(6): 872-878.
25.	Cheng AT, Backer CL, Holinger LD, et al. Histopathologic changes after pericardial patch tracheoplasty. Arch Otolaryngol Head Neck Surg, 1997, 123(10): 1069-1072.
26.	Tsang V, Murday A, Gillbe C, et al. Slide tracheoplasty for congenital funnel-shaped tracheal stenosis. Ann Thorac Surg, 1989, 48(5): 632-635.
27.	Grillo HC. Slide tracheoplasty for long-segment congenital tracheal stenosis. Ann Thorac Surg, 1994, 58(3): 613-619.
28.	Xue B, Liang B, Wang S, et al. One-stage surgical correction of cong-enital tracheal stenosis complicated with congenital heart disease in infants and young children. J Card Surg, 2015, 30(1): 97-103.
29.	Butler CR, Speggiorin S, Rijnberg FM, et al. Outcomes of slide tracheoplasty in 101 children: a 17-year single-center experience. J Thorac Cardiovasc Surg, 2014, 147(6): 1783-1789.
30.	Chung SR, Yang JH, Jun TG, et al. Clinical outcomes of slide tracheoplasty in congenital tracheal stenosis. Eur J Cardiothorac Surg, 2014, 47(3): 537-42.
31.	Toma M, Kamagata S, Hirobe S, et al. Modified slide tracheoplasty for congenital tracheal stenosis. J Pediatr Surg, 2009, 44(10): 2019-2022.
32.	Rutter MJ, Cotton RT, Azizkhan RG, et al. Slide tracheoplasty for the management of complete tracheal rings. J Pediatr Surg, 2003, 38(6): 928-934.
33.	Tsugawa C, Nishijima E, Muraji T, et al. Tracheoplasty for long segment congenital tracheal stenosis: analysis of 29 patients over two decades. J Pediatr Surg, 2003, 38(12): 1703-1706.
34.	Matute JA, Romero R, Garcia-Casillas MA, et al. Surgical approach to funnel-shaped congenital tracheal stenosis. J Pediatr Surg, 2001, 36(2): 320-323.
35.	Lang FJ, Hurni M, Monnier P. Long-segment congenital tracheal stenosis: treatment by slide-tracheoplasty. J Pediatr Surg, 1999, 34(8): 1216-1222.
36.	Jaquiss RD, Lusk RP, Spray TL, et al. Repair of long-segment tracheal stenosis in infancy. J Thorac Cardiovasc Surg, 1995, 110(5): 1504-1512.
37.	Grillo HC, Wright CD, Vlahakes GJ, et al. Management of conge-nital tracheal stenosis by means of slide tracheoplasty or resection and reconstruction, with long-term follow-up of growth after slide tracheoplasty. J Thorac Cardiovasc Surg, 2002, 123(1): 145-152.
38.	Neugebauer P, Endepols H, Mickenhagen A, et al. Ciliogenesis in submersion and suspension cultures of human nasal epithelial cells. Eur Arch Otorhinolaryngol, 2003, 260(6): 325-330.
39.	Bals R, Beisswenger C, Blouquit S, et al. Isolation and air-liquid interface culture of human large airway and bronchiolar epithelial cells. J Cyst Fibros, 2004, 3(Suppl 2):49-51.
40.	Jungebluth P, Alici E, Baiguera S, et al. Tracheobronchial transp-lantation with a stem-cell-seeded bioartificial nanocomposite: a proof-of-concept study. Lancet, 2011, 378(8): 1997-2004.
41.	Tan Q, Hillinger S, Van Blitterswijk CA, et al. Intra-scaffold continuous medium flow combines chondrocyte seeding and culture systems for tissue engineered trachea construction. Interact Cardiovasc Thorac Surg, 2009, 8(1): 27-30.
42.	Jungebluth P, Bader A, Baiguera S, et al. The concept of in vivo airway tissue engineering. Biomaterials, 2012, 33(17): 4319-4326.
43.	Elliott MJ, De Coppi P, Speggiorin S, et al. Stem-cell-based, tissue engineered tracheal replacement in a child: a 2-year follow-up study. Lancet, 2012, 380(6):994-1000.
44.	Mimouni-Benabu O, Meister L, Giordano J, et al. A preliminary study of computer assisted evaluation of congenital tracheal stenosis: a new tool for surgical decision-making. Int J Pediatr Otorhinolar-yngol, 2012, 76(11): 1552-1557.
45.	Ho CY, Liao HM, Tu CY, et al. Numerical analysis of airflow altera-tion in central airways following tracheobronchial stent placement. Exp Hematol Oncol, 2012, 1(1): 23.
46.	Qi S, Li Z, Yue Y, et al. Computational fluid dynamics simulation of airflow in the trachea and main bronchi for the subjects with left pulmonary artery sling. Biomed Eng Online, 2014, 24(13): 85.
47.	Chen FL, Horng TL, Shih TC. Simulation analysis of airflow alteration in the trachea following the vascular ring surgery based on CT images using the computational fluid dynamics method. J X-Ray Sci Technol, 2014, 22(2):213-225.
48.	张文韬. 3D打印气管给予婴儿第二次生命.世界科学, 2013, 9: 46-47.

1. Cantrell JR, Guild HG. Congenital stenosis of the trachea. Am J Surg, 1964, 108(8): 297-305.
2. Wolman IJ. Congenital stenosis of the trachea. Am J Dis Child, 1941, 61:1263-1271.
3. 徐志伟, 王顺民, 杜欣为, 等.小儿先天性心脏病伴气管狭窄的外科处理.中华外科杂志, 2014, 52(2): 127-130.
4. Anton-Pacheco JL, Cano I, Garcia A, et al. Patterns of management of congenital tracheal stenosis. J Pediatr Surg, 2003, 38(10): 1452-1458.
5. Cotton RT. Pediatric laryngotracheal stenosis. J Pediatr Surg, 1984, 19(6): 699-704.
6. Freitag L, Ernst A, Unger M, et al. A proposed classification system of central airway stenosis. Eur Respir J, 2007, 30(1): 7-12.
7. Anand VK, Alemar G, Warren ET. Surgical considerations in tracheal stenosis. Laryngoscope, 1992, 102(3): 237-243.
8. Myer CR, O'Connor DM, Cotton RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol, 1994, 103(4 Pt 1): 319-323.
9. Speggiorin S, Torre M, Roebuck DJ, et al. A new morphologic classification of congenital tracheobronchial stenosis. Ann Thorac Surg, 2012, 93(3): 958-961.
10. Herrera P, Caldarone C, Forte V, et al. The current state of congenital tracheal stenosis. Pediatr Surg Int, 2007, 23(11): 1033-1044.
11. Hoppe H, Dinkel HP, Walder B, et al. Grading airway stenosis down to the segmental level using virtual bronchoscopy. Chest, 2004, 125(2): 704-711.
12. Chiu PP, Kim PC. Prognostic factors in the surgical treatment of congenital tracheal stenosis: a multicenter analysis of the literature. J Pediatr Surg, 2006, 41(1): 221-225.
13. Harrison MR, Heldt GP, Brasch RC, et al. Resection of distal tracheal stenosis in a baby with agenesis of the lung. J Pediatr Surg, 1980, 15(6): 938-943.
14. Kleinhaus S, Winslow PR, Sheran M, et al. Evolution of individua-lized management of tracheal obstruction. J Pediatr Surg, 1978, 13(6D): 669-676.
15. Benjamin B, Pitkin J, Cohen D. Congenital tracheal stenosis. Ann Otol Rhinol Laryngol, 1981, 90(4 Pt 1): 364-371.
16. Grillo HC, Zannini P. Management of obstructive tracheal disease in children. J Pediatr Surg, 1984, 19(4): 414-416.
17. Nakayama DK, Harrison MR, De Lorimier AA, et al. Reconstructive surgery for obstructing lesions of the intrathoracic trachea in infants and small children. J Pediatr Surg, 1982, 17(6): 854-868.
18. Mansfield PB. Tracheal resection in infancy. J Pediatr Surg, 1980, 15(1): 79-81.
19. Anton-Pacheco JL, Cano I, Comas J, et al. Management of congenital tracheal stenosis in infancy. Eur J Cardiothorac Surg, 2006, 29(6): 991-996.
20. Kimura K, Mukohara N, Tsugawa C, et al. Tracheoplasty for conge-nital stenosis of the entire trachea. J Pediatr Surg, 1982, 17(6): 869-871.
21. Idriss FS, Deleon SY, Ilbawi MN, et al. Tracheoplasty with pericardial patch for extensive tracheal stenosis in infants and children. J Thorac Cardiovasc Surg, 1984, 88(4): 527-536.
22. Dunham ME, Holinger LD, Backer CL, et al. Management of severe congenital tracheal stenosis. Ann Otol Rhinol Laryngol, 1994, 103(5 Pt 1): 351-356.
23. Cohen RC, Filler RM, Konuma K, et al. A new model of tracheal stenosis and its repair with free periosteal grafts. J Thorac Cardiovasc Surg, 1986, 92(2): 296-304.
24. Ein SH, Friedberg J, Williams WG, et al. Tracheoplasty--a new operation for complete congenital tracheal stenosis. J Pediatr Surg, 1982, 17(6): 872-878.
25. Cheng AT, Backer CL, Holinger LD, et al. Histopathologic changes after pericardial patch tracheoplasty. Arch Otolaryngol Head Neck Surg, 1997, 123(10): 1069-1072.
26. Tsang V, Murday A, Gillbe C, et al. Slide tracheoplasty for congenital funnel-shaped tracheal stenosis. Ann Thorac Surg, 1989, 48(5): 632-635.
27. Grillo HC. Slide tracheoplasty for long-segment congenital tracheal stenosis. Ann Thorac Surg, 1994, 58(3): 613-619.
28. Xue B, Liang B, Wang S, et al. One-stage surgical correction of cong-enital tracheal stenosis complicated with congenital heart disease in infants and young children. J Card Surg, 2015, 30(1): 97-103.
29. Butler CR, Speggiorin S, Rijnberg FM, et al. Outcomes of slide tracheoplasty in 101 children: a 17-year single-center experience. J Thorac Cardiovasc Surg, 2014, 147(6): 1783-1789.
30. Chung SR, Yang JH, Jun TG, et al. Clinical outcomes of slide tracheoplasty in congenital tracheal stenosis. Eur J Cardiothorac Surg, 2014, 47(3): 537-42.
31. Toma M, Kamagata S, Hirobe S, et al. Modified slide tracheoplasty for congenital tracheal stenosis. J Pediatr Surg, 2009, 44(10): 2019-2022.
32. Rutter MJ, Cotton RT, Azizkhan RG, et al. Slide tracheoplasty for the management of complete tracheal rings. J Pediatr Surg, 2003, 38(6): 928-934.
33. Tsugawa C, Nishijima E, Muraji T, et al. Tracheoplasty for long segment congenital tracheal stenosis: analysis of 29 patients over two decades. J Pediatr Surg, 2003, 38(12): 1703-1706.
34. Matute JA, Romero R, Garcia-Casillas MA, et al. Surgical approach to funnel-shaped congenital tracheal stenosis. J Pediatr Surg, 2001, 36(2): 320-323.
35. Lang FJ, Hurni M, Monnier P. Long-segment congenital tracheal stenosis: treatment by slide-tracheoplasty. J Pediatr Surg, 1999, 34(8): 1216-1222.
36. Jaquiss RD, Lusk RP, Spray TL, et al. Repair of long-segment tracheal stenosis in infancy. J Thorac Cardiovasc Surg, 1995, 110(5): 1504-1512.
37. Grillo HC, Wright CD, Vlahakes GJ, et al. Management of conge-nital tracheal stenosis by means of slide tracheoplasty or resection and reconstruction, with long-term follow-up of growth after slide tracheoplasty. J Thorac Cardiovasc Surg, 2002, 123(1): 145-152.
38. Neugebauer P, Endepols H, Mickenhagen A, et al. Ciliogenesis in submersion and suspension cultures of human nasal epithelial cells. Eur Arch Otorhinolaryngol, 2003, 260(6): 325-330.
39. Bals R, Beisswenger C, Blouquit S, et al. Isolation and air-liquid interface culture of human large airway and bronchiolar epithelial cells. J Cyst Fibros, 2004, 3(Suppl 2):49-51.
40. Jungebluth P, Alici E, Baiguera S, et al. Tracheobronchial transp-lantation with a stem-cell-seeded bioartificial nanocomposite: a proof-of-concept study. Lancet, 2011, 378(8): 1997-2004.
41. Tan Q, Hillinger S, Van Blitterswijk CA, et al. Intra-scaffold continuous medium flow combines chondrocyte seeding and culture systems for tissue engineered trachea construction. Interact Cardiovasc Thorac Surg, 2009, 8(1): 27-30.
42. Jungebluth P, Bader A, Baiguera S, et al. The concept of in vivo airway tissue engineering. Biomaterials, 2012, 33(17): 4319-4326.
43. Elliott MJ, De Coppi P, Speggiorin S, et al. Stem-cell-based, tissue engineered tracheal replacement in a child: a 2-year follow-up study. Lancet, 2012, 380(6):994-1000.
44. Mimouni-Benabu O, Meister L, Giordano J, et al. A preliminary study of computer assisted evaluation of congenital tracheal stenosis: a new tool for surgical decision-making. Int J Pediatr Otorhinolar-yngol, 2012, 76(11): 1552-1557.
45. Ho CY, Liao HM, Tu CY, et al. Numerical analysis of airflow altera-tion in central airways following tracheobronchial stent placement. Exp Hematol Oncol, 2012, 1(1): 23.
46. Qi S, Li Z, Yue Y, et al. Computational fluid dynamics simulation of airflow in the trachea and main bronchi for the subjects with left pulmonary artery sling. Biomed Eng Online, 2014, 24(13): 85.
47. Chen FL, Horng TL, Shih TC. Simulation analysis of airflow alteration in the trachea following the vascular ring surgery based on CT images using the computational fluid dynamics method. J X-Ray Sci Technol, 2014, 22(2):213-225.
48. 张文韬. 3D打印气管给予婴儿第二次生命.世界科学, 2013, 9: 46-47.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Progress on Diagnosis and Treatment of Congenital Tracheal Stenosis

Abstract Full text Figures/Tables Video References Cited by

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