[The treatment of laryngeal stenosis in the child. 156 cases (author's transl)].

156 cases of laryngeal stenosis in the child were seen over a 10 year period. 40 were congenital and 116 acquired, chiefly after intubation. Congenital stenosis improved spontaneously in 60 % of cases. When tracheotomy was necessary, treatment was similar to that of acquired stenosis. For post-intubation stenosis analysis of the underlying pathology revealed the existence of risk factors: coma, cardiac surgery with extracorporeal circulation, laryngaeal pathology being responsible in 75 % of cases. Awareness of these risk factors was felt to be one of the essential elements in the prevention of post-intubation stenosis. Treatment varied in accordance with the degree of progression of the stenosis. In recent progressive forms medical and endoscopic treatment (51 cures without treacheotomy, 11 after tracheotomy for 2 to 10 weeks). In forms with scar tissue, tracheotomy associated with endolaryngeal calibration (21 cases) or laryngotracheal enlargement surgery (21 cases). A number of precautions are suggested in order to improve the prevention of stenosis with scar tissue. Indications of the various therapeutic methods are discussed according to whether the stenosis is due to scar tissue or is congenital. With regard to procedures involving laryngotracheal widening (28 in all : 21 for stenosis after intubation and 7 for congenital stenosis), emphasis placed upon the need to select amongst several types of operation according to the site and extent of the lesions.