[Paediatric laryngotracheal stenosis: pattern of care in Germany]

Abstract

Background: Stenoses of the larynx and upper trachea in the pediatric population require a multidisciplinary approach and center-based treatment. Patterns of care and treatment strategies in Germany were evaluated using a standardized questionnaire.

Material and methods: A questionnaire was transmitted by telefax to 141 departments of Otorhinolaryngology (ORL) and to 214 pediatric (PED) departments. Using primarily multiple-choice questions variables regarding caseload, surgical techniques, cooperating institutions, criteria for surgical indications and subjective assessment of success rates were investigated.

Results: The response rate was 55% (ORL) and 46% (PED), respectively, 34% of the replying ORL departments were offering tracheal surgery in children, with most of them using advanced surgical techniques. In 12 ORL departments 1-3 cases per year were operated, in 6 ORL departments more than 6 cases per year and 3 ORL departments were perceived as specialized centers for pediatric airway surgery by their peers. However, 41% of the PED departments were unable to identify a center for pediatric airway surgery.

Conclusion: In Germany, surgery for pediatric airway stenoses is not primarily focused on treatment centers. There is a significant information gap among German pediatricians regarding success rates of reconstructive airway surgery and available centers offering surgical therapy for this population. Several factors offer potential to be optimized in the care for children with a compromised airway and improving communication between otolaryngologists and pediatricians should be a primary goal in the future.