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Paediatric subglottic stenosis - Have things changed? Our experience from a developing tertiary referral centre

Rishi Talwar1, Jagdeep Singh Virk1, Yogesh Bajaj1

  • 1ENT Department, Barts Children's and the Royal London Hospital, United Kingdom.

International Journal of Pediatric Otorhinolaryngology
|September 13, 2015
PubMed

Insights

Subglottic stenosis (SGS) is a common pediatric airway issue. Endoscopic management is increasingly effective, potentially reducing the need for tracheostomy or laryngotracheal reconstruction in affected children.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Pulmonology
  • Pediatric Critical Care

Background:

  • Pediatric airway disorders are prevalent, especially in neonatal intensive care units.
  • Current management strategies for subglottic stenosis lack standardization.

Purpose of the Study:

  • To evaluate the incidence, severity, treatment, and outcomes of subglottic stenosis in children.
  • To analyze patient data from a developing tertiary referral center.

Main Methods:

  • A 19-month prospective longitudinal study.
  • Inclusion of all patients undergoing microlaryngobronchoscopy (MLB).
  • Intraoperative grading of subglottic stenosis (SGS) using the Myer-Cotton classification.

Main Results:

  • 102 patients underwent MLB; 33 (32.4%) were diagnosed with SGS.
  • Most SGS cases were Grade 1 (66.7%), with fewer Grade 2 (21.2%) and Grade 3 (12.1%).
  • Patients underwent an average of 2.21 MLBs with interventions, including endoscopic procedures, tracheostomy (2/33), and laryngotracheal reconstruction (LTR) (2/33).

Conclusions:

  • Subglottic stenosis presentation and management appear to be evolving.
  • Endoscopic interventions may reduce the need for tracheostomy or LTR.
  • Further long-term prospective studies are warranted to confirm these trends.
Abstract

Keywords:
EndoscopeLaryngotracheal reconstructionPaediatricStridorSubglottic stenosis

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