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Lyell’s syndrome as a factor which escalates the risk of laryngotracheal stenosis and atresia after intubation

100%
Nowak N., Kotowski M., Sroczyński J., Szydłowski J.
Polski Przegląd Otorynolaryngologiczny
|
2019
|
vol. 8(3)
50-54
EN
Toxic epidermal necrolysis (TEN) also known as Lyell’s Syndrome is a rare, acute hypersensitivity reaction characterized by cutaneous and mucosal necrosis covering more than 30% of surface [1]. Lyell’s syndrome is self limited, but potentially recurrent disease. The mortality for toxic epidermal necrolysis is approaching to 20–66% [2]. Lyell Syndrome is extremely rare diseases with an estimated overall incidence of 1–2 per 1 million inhabitants per year [3]. TEN is more common in women, it can occur at any age, whereas mostly occurs in older patients in their fifth to seventh decades. Death is caused either by sepsis or by respiratory distress which is either due to pneumoniae or damage to the linings of the airway [4]. Subglottic stenosis is the most common anomaly of larynx and trachea requiring tracheostomy in pediatric population [5]. Subglottic part of larynx is the narrowest section of laryngotracheal area of airways in childhood [5]. It is estimated that most of subglottic stenosis cases is acquired and developed as a result of injury caused by long-term use of endotracheal tube,only 5% of subglottic stenosis is congenital [6]. Latest improvements about construction of endotracheal tube and rules of procedures reduced frequency of subglottic stenosis to less than 1%. There are no statistics or medical reports about tracheal atresia caused by intubation or Lyell’s syndrome. This situation forced us to recognise Lyell’s syndrome and endotracheal intubation overlapping on each other as a cause of medical state of our 2 years old patient.
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Experiences with treatment of extended laryngo-tracheal stenosis with employment of transversal resection of trachea

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Szyfter W., Nowak K., Kruk-Zagajewska A.
Otolaryngologia Polska
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2008
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vol. 62(6)
695-699
EN
The aim of this study is to evaluate the results obtained in Department of Otolaryngology et Oncology with transversal resection of trachea acc. to Pearson technique for postintubation stenosis. Methods. from January 2000 to January 2008 ten patients with subglottic postintubation stenosis underwent surgical treatment, using Pearsons method of operation with preservation of recurrent nerves and no postopereative tracheostomy. Mean stenosis length was 2 cm, the length of of airway resection was 1,5–4 cm. Results. There was no surgical or postoperative complications, all the patients get totally health, no restenosis was observed. The results confi rm that the Pearsons method of operation is an adequate treatment for subglottic stenosis.
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