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Safe balloon sizing for endoscopic dilatation of subglottic stenosis in children
S D Sharma1, S L Gupta1, M Wyatt1
1Department of Paediatric Otorhinolaryngology,Great Ormond Street Hospital for Children,London,UK.
Insights
This study provides guidelines for safe balloon dilatation in children with airway stenosis. Recommended balloon sizes correlate with patient age, ensuring a safe and effective procedure.
Area of Science:
- Pediatric Otolaryngology
- Interventional Pulmonology
- Pediatric Airway Management
Background:
- Subglottic stenosis is a common airway complication in children.
- Balloon dilatation is a frequently used treatment modality for pediatric airway stenosis.
Purpose of the Study:
- To establish evidence-based guidelines for selecting maximum safe balloon sizes for pediatric balloon dilatation.
- To describe the safety and efficacy of balloon dilatation for subglottic stenosis in children.
Main Methods:
- Retrospective review of 166 pediatric patients undergoing balloon dilatation for subglottic stenosis.
- Analysis of patient age, balloon size, inflation pressure, and duration.
- Correlation analysis between patient age and balloon size.
Main Results:
- A strong positive correlation (r=0.85, p=0.001) was found between patient age and optimal balloon size.
- The procedure demonstrated a high safety profile with no significant unexpected events.
- Median balloon size used was 8 mm with a median inflation pressure of 10 atm for 65.1 seconds.
Conclusions:
- Balloon dilatation is a safe and effective intervention for pediatric airway stenosis.
- Recommended balloon diameter: age-appropriate endotracheal tube outer diameter +1 mm (larynx/subglottis) or +2 mm (trachea).
- These guidelines can optimize treatment and improve outcomes for children with airway stenosis.
Objectives:
To describe our experience and provide guidelines for maximum safe balloon sizes according to age in children undergoing balloon dilatation.
Method:
A retrospective review was conducted of children undergoing balloon dilatation for subglottic stenosis in a paediatric tertiary unit between May 2006 and February 2016.
Results:
A total of 166 patients underwent balloon dilatation. Mean ( ± standard deviation) patient age was 4.5 ± 3.99 years. The median balloon size was 8 mm, the median balloon inflation pressure was 10 atm, and the mean balloon inflation time was 65.1 ± 18.6 seconds. No significant unexpected events occurred. The Pearson correlation co-efficient for the relationship between patient age and balloon size was 0.85 (p = 0.001), suggesting a strongly positive correlation.
Conclusion:
This study demonstrated that balloon dilatation is a safe procedure for airway stenosis. The results suggest using a balloon diameter that is equal to the outer diameter of the age-appropriate endotracheal tube +1 mm for the larynx and subglottis and +2 mm for the trachea.
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