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[Balloon laryngoplasty for acquired subglottic stenosis in children: predictive factors for success]
Rebecca Maunsell1, Melissa A G Avelino2
1Hospital de Sumaré, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
Insights
Balloon laryngoplasty offers a promising treatment for pediatric subglottic stenosis. While highly effective for acute cases, its success in chronic conditions is moderate, with minimal complications.
Area of Science:
- Otorhinolaryngology
- Pediatric Surgery
- Airway Management
Context:
- Subglottic stenosis in children presents significant treatment challenges.
- Current management often involves complex endoscopic or open surgical procedures.
- Balloon laryngoplasty is explored as a primary intervention.
Purpose:
- To evaluate the efficacy and safety of balloon laryngoplasty for acquired subglottic stenosis in pediatric patients.
- To identify factors predicting successful outcomes and complications associated with this technique.
- To report findings from two tertiary care centers.
Summary:
- A prospective study involved 37 children with acquired subglottic stenosis treated with balloon laryngoplasty.
- Success rates were 100% for acute and 32% for chronic stenosis.
- Factors associated with success included acute presentation, lower stenosis grade, younger age, and no prior tracheostomy. Transient dysphagia was the sole complication.
Impact:
- Balloon laryngoplasty can be considered a primary treatment option for pediatric subglottic stenosis.
- The procedure demonstrates high efficacy in acute cases and acceptable safety in chronic cases.
- Findings guide clinical decision-making, preserving options for open surgery if needed.
Introduction:
The treatment of subglottic stenosis in children remains a challenge for the otorhinolaryngologist, and may involve both endoscopic and open surgery.
Objective:
To report the experience of two tertiary facilities in the treatment of acquired subglottic stenosis in children with balloon laryngoplasty, and to identify predictive factors for success of the technique and its complications.
Methods:
Descriptive, prospective study of children diagnosed with acquired subglottic stenosis and submitted to balloon laryngoplasty as primary treatment.
Results:
Balloon laryngoplasty was performed in 37 children with an average age of 22.5 months; 24 presented chronic subglottic stenosis and 13 acute subglottic stenosis. Success rates were 100% for acute subglottic stenosis and 32% for chronic subglottic stenosis. Success was significantly associated with acute stenosis, initial grade of stenosis, children of a smaller age, and the absence of tracheostomy. Transitory dysphagia was the only complication observed in three children.
Conclusion:
Balloon laryngoplasty may be considered the first line of treatment for acquired subglottic stenosis. In acute cases, the success rate is 100%, and although the results are less promising in chronic cases, complications are not significant and the possibility of open surgery remains without prejudice.
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