Management of Paediatric Airway in Post-intubation Subglottic Stenosis Associated with Japanese Encephalitis

Area of Science:

• Otolaryngology
• Pediatric Critical Care
• Infectious Diseases

Background:

• Subglottic stenosis, a narrowing between the vocal cords and cricoid cartilage, can lead to significant respiratory compromise.
• Post-intubation subglottic stenosis is a known complication, particularly in pediatric patients with severe illnesses like Japanese encephalitis.
• Effective management strategies are crucial for improving airway patency and quality of life.

Purpose of the Study:

• To investigate the management of pediatric airway in cases of post-intubation subglottic stenosis associated with Japanese encephalitis.
• To evaluate different treatment approaches and their impact on patient outcomes.
• To identify optimal interventions for this specific patient population.

Main Methods:

• Retrospective study of 18 patients with encephalitis, identifying 6 cases of post-intubation subglottic stenosis linked to Japanese encephalitis.
• Analysis of treatment strategies employed over a one-year period.
• Review of patient data regarding intubation duration, tracheostomy tube type, and procedural interventions.

Main Results:

• Fifteen patients underwent treatment during the study period using various approaches.
• The duration of intubation was a key factor influencing the development of subglottic stenosis.
• Bronchoscopic-assisted procedures, performed during or after tracheostomy, were found to reduce morbidity.
• The Bivona® silicone tracheostomy tube emerged as a preferred option for improving post-tracheostomy quality of life.

Conclusions:

• Management of pediatric airway in post-intubation subglottic stenosis associated with Japanese encephalitis necessitates a well-defined strategy.
• Intensive and dedicated post-operative care is paramount for successful outcomes.
• The use of Bivona® silicone tracheostomy tubes and timely bronchoscopic interventions are recommended.