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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
Summary
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.
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