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Balloon dilation laryngoplasty for subglottic stenosis in children: eight years' experience
Charlotte Hautefort1, Natacha Teissier, Paul Viala
1Department of Otolaryngology-Head and Neck Surgery, Robert Debré Hospital, APHP, University Paris VII Denis-Diderot, Paris, France.
Insights
Balloon dilation laryngoplasty is an effective treatment for pediatric laryngeal stenosis, showing a 71% success rate. This safe procedure offers a viable option for both primary and secondary cases in children.
Area of Science:
- Pediatric Otolaryngology
- Laryngeal Surgery
- Medical Device Technology
Background:
- Laryngeal stenosis in children can result from congenital or acquired causes.
- Treatment options for pediatric laryngeal stenosis are varied, with surgical interventions often required.
- Balloon dilation offers a less invasive approach to managing airway obstruction.
Purpose of the Study:
- To evaluate the outcomes of balloon dilation laryngoplasty in pediatric patients with laryngeal stenosis.
- To assess the efficacy and safety of this minimally invasive technique.
- To compare success rates for primary versus secondary balloon dilation procedures.
Main Methods:
- Retrospective study of 44 children (1 month to 10 years) treated between 2002 and 2010.
- Patients had varying degrees of laryngeal stenosis (Grades II-IV), both congenital and acquired.
- Outcomes were assessed based on the success of balloon dilation, with stenosis severity classified using the Cotton and Myer system.
Main Results:
- A total of 52 balloon dilation laryngoplasties were performed, with an overall success rate of 71% (37 out of 44 patients).
- Primary balloon dilation had a 65% success rate (20/31), while secondary dilation after surgery achieved 81% success (17/21), avoiding further surgical revision.
- Unsuccessful primary dilations (11 patients) required laryngotracheal reconstruction or tracheotomy.
Conclusions:
- Balloon dilation laryngoplasty is an efficient and safe treatment for pediatric laryngeal and tracheal stenosis.
- The procedure demonstrates a higher success rate when used as a secondary intervention following open surgery.
- This technique provides a valuable therapeutic option for managing airway compromise in children.
Objective:
To evaluate outcomes of balloon dilation laryngoplasty for laryngeal stenosis in children.
Design:
Retrospective study.
Setting:
Academic tertiary care department of pediatric otolaryngology.
Patients:
All children treated with laryngeal balloon dilation (primarily or secondarily following laryngeal surgery) from 2002 to 2010.
Main Outcome Measures:
Stenosis severity, measured using the Cotton and Myer classification.
Results:
A total of 44 children ranging in age from 1 month to 10 years (14 [32%] with grade II stenosis, 25 [59%] with grade III stenosis, and 4 [9%] with grade IV stenosis) were included. Twelve children [27%] had congenital laryngeal stenoses, and the in other 32 [7 3%], stenosis was acquired. A total of 52 balloon dilation laryngoplasties were performed, and 37 (71%) were deemed successful. Twenty of the 31 patients undergoing primary dilation (65%) had successful outcomes, and in the other 11 [35%], outcomes were unsuccessful (4 had grade II stenosis and 7 had grade III stenosis) and required either laryngotracheal reconstruction or tracheotomy. Twenty-one balloon dilations were performed as a secondary procedure after recent open surgery; 17 of the procedures (81%) were successful, and thus surgical revision was avoided.
Conclusion:
Balloon dilation laryngoplasty is an efficient and safe technique for the treatment of both primary and secondary pediatric laryngotracheal stenosis.
