Congenital tracheal stenosis managed conservatively: systematic review of the literature.
Bibliographic record
Abstract
OBJECTIVE: Congenital tracheal stenosis (CTS) is challenging. Its natural history and epidemiology are poorly described. Information is scarce on cases not undergoing surgery. METHODS: A retrospective review of patients with CTS in one pediatric otolaryngology practice was performed. A Medline search of English publications from 1966 to 2008 was conducted using the terms "CTS," "management of CTS," and "slide tracheoplasty." RESULTS: Four patients were diagnosed over 5.5 years. Diagnosis was achieved within 4 months of life in three and at 13 years of age in one. Three children presented with difficulty to ventilate in the neonatal intensive care unit. One was diagnosed with asthma early in life. Other congenital abnormalities were encountered in three patients. One child required a tracheostomy due to respiratory failure, for reasons other than CTS. None required surgical repair, and conservative management was pursued. Three patients were followed for 5 years. Our search yielded 20 relevant reports from 1996 to 2008. All were retrospective case series. A total of 310 patients with a mean age of 17.14 months (± 24.10) were used in our analysis. The male to female ratio of those reported was 1.7:1. The mean follow-up was 5.1 years. Thirty-five to 43% of patients had no qualified indications for their surgical management. Mortality and complication rates make tracheal repair a significant undertaking. Little is reported on the long-term outcomes, swallowing functions, and quality of life of patients repaired who did not require immediate interventions. CONCLUSION: There is a need to identify specific indications for surgery and a stratification of successful candidates by various disease-related factors. If the difficulties weaning from assisted ventilation or coping with growth and activity requirements are circumvented, children may be managed conservatively.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.008 | 0.011 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".