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Stridor and severe subglottic stenosis: emergency tracheostomy for a neonate with a pinhole trachea
  1. Paul Jerome Ryan1,
  2. Caoimhe Casby1,
  3. John Russell2 and
  4. Francesca Holt1
  1. 1 Department of Anaesthesia and Intensive Care Medicine, Children's Health Ireland at Crumlin, Dublin, Ireland
  2. 2 Department of Paediatric Otorhinolaryngology, Children's Health Ireland at Crumlin, Dublin, Ireland
  1. Correspondence to Dr Paul Jerome Ryan; pauljeromeryano30{at}


Congenital subglottic stenosis is a rare but potentially catastrophic condition. In this report, we describe the management of a term neonate who was noted to have biphasic stridor during preassessment for correction of an imperforate anus at 26 hours of life. The neonate was found to have a pinhole trachea secondary to congenital subglottic stenosis. It was impossible to pass an endotracheal tube, so the neonate underwent an emergency surgical tracheostomy with a good outcome. A high index of suspicion led to appropriate steps being taken to safely anaesthetise the neonate.

  • Anaesthesia
  • Ear, nose and throat/otolaryngology
  • Congenital disorders
  • Neonatal and paediatric intensive care

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  • Contributors All authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content. All authors gave final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.