Acute obstructing lesions of the distal (lower) trachea present a unique challenge to the pediatric otolaryngologist. The small caliber of the airway and tenuous medical status of such patients test the ingenuity of the surgeon and the limits of instrumentation. This report presents the operative findings and management of four hospitalized infants with worsening respiratory distress. Difficulties encountered in maintaining airway control while diagnosing and correcting these lesions are described.
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