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Neonatal subglottic stenosis--incidence and trends
D L Walner1, M S Loewen, R E Kimura
1Department of Otolaryngology and Bronchoesophagology, Rush-Presbyterian-St Luke's Medical Center, Chicago, Illinois 60012, USA.
The Laryngoscope
|February 24, 2001
Summary
Neonatal subglottic stenosis incidence has decreased significantly, with no cases found in a 1997 study. This suggests improved neonatal care has lowered risks associated with endotracheal intubation.
Area of Science:
- Neonatal intensive care
- Pediatric otolaryngology
- Respiratory medicine
Background:
- Neonatal subglottic stenosis is a recognized complication of endotracheal intubation.
- Historical incidence rates in the 1970s-1980s ranged from 0.9% to 8.3% for intubated neonates.
- Advances in neonatal ventilatory support techniques may have reduced stenosis rates.
Purpose of the Study:
- To evaluate the incidence of neonatal subglottic stenosis in the late 1990s.
- To determine if improved neonatal care techniques have lowered the occurrence of this condition.
Main Methods:
- Retrospective review of neonatal intensive care unit (NICU) admissions from 1997.
- MEDLINE search for reported neonatal subglottic stenosis incidence (1960-1999).
- Analysis of patient data including gestational age, birth weight, intubation duration, and tracheostomy rates.
Main Results:
- In 1997, 281 of 544 neonates were intubated for an average of 11 days; no subglottic stenosis cases were observed.
- Literature review indicated a declining trend: incidence <4.0% after 1983 and <0.63% after 1990.
- Three neonates required tracheostomy for reasons unrelated to subglottic stenosis.
Conclusions:
- A downward trend in neonatal subglottic stenosis incidence is evident, particularly in the late 1990s.
- The current incidence is estimated to be between 0.0% and 2.0%.
- Improved neonatal care likely contributes to the reduced rates of this complication.