Randomized Controlled Trial of Balloon Dilation in Treatment of Subglottic Stenosis With a Rabbit Model

Area of Science:

• Otolaryngology
• Regenerative Medicine
• Animal Models

Background:

• Subglottic stenosis is a serious airway complication.
• Endoscopic balloon dilation is a common treatment, but optimal parameters are unclear.

Purpose of the Study:

• To evaluate the impact of balloon dilation duration and topical antibiotic-steroid application on subglottic stenosis treatment.
• To compare short-duration balloon dilation (SBD), long-duration balloon dilation (LBD), and LBD with topical ciprofloxacin-dexamethasone (LBD+C).

Main Methods:

• A randomized controlled trial was conducted on 44 rabbits with induced subglottic injury.
• Rabbits received endoscopic balloon dilation for 3 seconds (SBD), 30 seconds (LBD), or LBD with topical ciprofloxacin-dexamethasone (LBD+C).
• Stenosis was measured 1 month post-dilation or upon development of respiratory distress.

Main Results:

• Among rabbits with grade III stenosis, LBD+C showed the greatest improvement in stenosis (-1% for SBD, 27% for LBD, 58% for LBD+C; P=.01).
• Early mortality rates were significantly lower in the LBD+C group (17%) compared to LBD (63%) and SBD (85%; P=.03).
• LBD+C also demonstrated a longer time to euthanasia/death compared to SBD.

Conclusions:

• Short-duration balloon dilation is less effective for subglottic stenosis in rabbits.
• Long-duration balloon dilation combined with topical ciprofloxacin-dexamethasone significantly improves stenosis reduction and reduces mortality.
• Further research is required to determine optimal balloon dilation durations for clinical application.