Impact of balloon laryngoplasty on management of acute subglottic stenosis.

Abstract

PURPOSE:

To assess the impact of balloon laryngoplasty on clinical and surgical outcomes in pediatric patients with acute subglottic stenosis.

METHODS:

Two case series were included and compared. The first group included patients treated initially either with tracheostomy (if severe symptoms) or with close follow-up (if mild symptoms). Those children underwent re-evaluation and specific treatment of their stenosis with laser incisions or open surgeries some weeks later. The other group included children treated initially with balloon laryngoplasty, reflecting a shift in surgical practice after 2009. Data as success of the procedure, mean hospital stay, mean pediatric intensive care unit (PICU) stay, post-procedure fever, need of antibiotics, procedure-related complications, and deaths were assessed and compared between both cohorts.

RESULTS:

The sample comprised 38 pediatric patients aged 0-5 years. Fifteen children were treated before 2009, of who 10 (66.7%) required tracheostomy soon after the diagnosis. Ultimately, 13 (86.6%) underwent laryngotracheal reconstruction. Twenty-three children were treated after 2009 and the success rate in these patients treated primarily with balloon laryngoplasty was 82.6%. Of these, only 3 (13%) required tracheostomy and 1 (4.3%) required further open laryngotracheal reconstruction. Patients treated by balloon laryngoplasty underwent fewer procedures under general anesthesia and had a lower burden of treatment-related morbidity, as denoted by shorter PICU stay, less antibiotic use, earlier postoperative resumption of oral feeding, and a lower incidence of postoperative complications and fever.

CONCLUSION:

When used for management of acute laryngeal stenosis, balloon laryngoplasty is associated with a high success rate, presenting lower morbidity than open surgery.

• Authors: Andréia Melchiors Wenzel, Cláudia Schweiger, Denise Manica, Leo Sekine, Isabel Cristina Schütz Ferreira, Gabriel Kuhl, Paulo José Cauduro Marostica
• Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Eur Arch Otorhinolaryngol) Vol. 275 Issue 9 Pg. 2325-2331 (Sep 2018) ISSN: 1434-4726 [Electronic] Germany
• PMID: 30008140 (Publication Type: Journal Article)

Topics

• Acute Disease
• Child, Preschool
• Cohort Studies
• Constriction, Pathologic (surgery)
• Female
• Humans
• Infant
• Infant, Newborn
• Laryngoplasty (adverse effects)
• Laryngostenosis (surgery)
• Male
• Postoperative Complications (epidemiology)
• Tracheostomy (adverse effects)
• Treatment Outcome