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Published on: June 20, 2018
Long-term outcomes of balloon dilation for acquired subglottic stenosis in children
Aliye Filiz1, Seckin O Ulualp1
1Department of Otolaryngology-Head and Neck Surgery, Division of Pediatric Otolaryngology, University of Texas Southwestern Medical Center and Children's Medical Center, 5323 Harry Hines, Dallas, TX 75390-9035, USA.
Insights
Serial balloon dilation is a safe and effective treatment for acquired subglottic stenosis in children, offering long-term symptom resolution without recurrence in a follow-up exceeding one year.
Area of Science:
- Pediatric Otolaryngology
- Interventional Pulmonology
Background:
- Acquired subglottic stenosis in children often results from prolonged intubation.
- Traditional open surgical repair carries significant risks.
- Balloon dilation presents a less invasive alternative.
Purpose of the Study:
- To evaluate the long-term outcomes of balloon dilation for acquired subglottic stenosis in pediatric patients.
- To assess the safety and efficacy of serial balloon dilations.
Main Methods:
- Retrospective review of medical charts for children treated with balloon dilation for subglottic stenosis.
- Data collection included patient demographics, clinical presentation, stenosis grading, and procedural details.
- Outcomes assessed via symptom improvement, complication rates, and need for further interventions.
Main Results:
- Three pediatric patients (14 weeks to 1 year old) with subglottic stenosis (Grades II-III) underwent 2-3 serial balloon dilations over 2-10 weeks.
- All patients experienced resolution of stridor and reduced work of breathing.
- No recurrence of stenosis was observed during a 14-21 month follow-up period.
Conclusions:
- Serial balloon dilation is a safe and successful therapeutic option for acquired subglottic stenosis in children.
- This minimally invasive approach provides durable, long-term results.
- It offers a viable alternative to open surgical interventions.
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.
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