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Long-Term Outcomes of Balloon Dilation for Acquired Subglottic Stenosis in Children

DOI: 10.1155/2014/304593

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Abstract:

Objectives. Balloon dilation laryngoplasty has been suggested as an alternative treatment to open surgical treatment of acquired subglottic stenosis in children. We describe long-term outcomes of balloon dilation for acquired subglottic stenosis in children. Methods. The medical charts of children who had balloon dilation for subglottic stenosis secondary to intubation were reviewed. Data included demographics, relevant history and physical examination, diagnostic workup, and management. Outcomes of balloon dilation were assessed based on improvement in preoperative symptoms, grading of stenosis, complications, and need for additional procedures. Results. Three children (2 male, 1 female, age range: 14 weeks–1 year) underwent balloon dilation for acquired subglottic stenosis. Patients presented with stridor and increased work of breathing. Duration of intubation ranged from 2 days to 3 weeks. Patients became symptomatic 5 days to 6 weeks after extubation. Grade of subglottic stenosis was II in 2 patients and III in one. Subglottic stenosis patients had 2-3 dilations within 2–10 weeks. All patients were asymptomatic during 14–21-month follow-up. Conclusions. Serial balloon dilation was safe and successful method to manage acquired subglottic stenosis in this group of children. No recurrence was noted in a follow-up more than a year after resolution of symptoms. 1. Introduction Acquired subglottic stenosis in children has been treated using a wide variety of approaches such as observation, dilation, laser, single or multistage open surgical reconstructions, and tracheostomy. With the advent of high-pressure, noncompliant airway balloons, balloon laryngoplasty has been increasingly used for treatment of acquired subglottic stenosis in children. Balloon dilation of the airway provides an opportunity to apply radial force to subglottic narrowing and prevents shearing forces created by rigid dilators [1]. Serial balloon dilations may be needed and open procedures may be avoided in some patients. Outcomes of balloon dilation in children have been increasingly investigated. Nevertheless, long-term outcomes of balloon dilation for acquired subglottic stenosis have not been established in children. The aim of the present study is to describe long-term outcomes of balloon dilation for acquired subglottic stenosis in children. 2. Case Reports The medical charts of children who had balloon dilation for subglottic stenosis secondary to intubation were reviewed. Data included demographics, relevant history and physical examination, diagnostic workup, and management.

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