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Child with tracheostomy. Young girl aged 2 1/2 years with a permanent tracheostomy vent, seen with her family. The girl has a congenital subglottic stenosis (SGS) grade 3, a narrowing of the subglottic airway where it passes through the ring-shaped cricoid cartilage. Grade 3 indicates the blockage is between 50% and 99%. A tracheostomy tube has been inserted below the cricoid to allow normal breathing. However this is below the larynx so the child is unable to talk normally and uses sign language to communicate. Treatment of SGS is normally by surgery, either by splitting the cricoid and grafting inserts of cartilage or by resection of the trachea. Congenital SGS is realtively rare, but is the third most common congenital airway problem.
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