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Endoscopic balloon dilatation for pediatric subglottic stenosis: a meta-analysis of successful outcomes
Abdullah Ahmed Alamri1, Majed N Alnefaie2, Omar A Alsulami3
1Otolaryngology head and neck surgery, Taibah University, Medina, Saudi Arabia. Dr.abdullah125@gmail.com.
Insights
Endoscopic balloon dilation (EBD) is a successful treatment for pediatric subglottic stenosis (SGS), with a 76% success rate. While complications are rare, severity of SGS may impact treatment outcomes.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Respiratory Medicine
Background:
- Subglottic stenosis (SGS) is a critical airway issue in pediatric patients.
- Endoscopic balloon dilation (EBD) is a minimally invasive treatment option for pediatric SGS.
- Optimal patient selection and success rates for EBD require further investigation.
Purpose of the Study:
- To systematically review and assess the efficacy of primary endoscopic balloon dilation (EBD) for pediatric subglottic stenosis (SGS).
- To determine the success rate of EBD in managing pediatric SGS.
- To identify patient characteristics associated with successful EBD outcomes.
Main Methods:
- A systematic review and meta-analysis was conducted.
- Literature search included PubMed, EBSCO, and Web of Science&MEDLINE.
- 14 studies comprising 473 pediatric SGS cases were analyzed.
Main Results:
- The pooled success rate for EBD in pediatric SGS was 76% (95% CI: 0.65-0.86).
- High heterogeneity was observed across studies (I² = 91%).
- Reported complications were uncommon but could be serious.
Conclusions:
- Endoscopic balloon dilation demonstrates a high success rate for pediatric subglottic stenosis.
- Patient selection, potentially based on SGS severity, may influence treatment success.
- EBD is a viable therapeutic option for pediatric SGS, though careful consideration of potential risks is warranted.
Objectives:
The primary goal of this study was to systematically identify all relevant published articles on the use of primary endoscopic balloon dilation for the management of pediatric patients with subglottic stenosis, critically assess the technique's success, and determine which patients are the best candidates for the procedure.
Methodology:
This was a systematic review and meta-analysis that aimed to investigate the use and success rate of EBD for treating pediatric SGS. An electronic systematic literature search of three major databases, PubMed, EBSCO, and Web of Science&MEDLINE through Clarivate, was conducted to include the eligible articles.
Results:
A total of 14 unique studies were included in the final analysis, with 473 cases of pediatric SGS. The pooled success rate of EBD in treatment of pediatric SGS was 76% (k = 14 studies, 95% confidence interval [CI] = 0.65-0.86, P < 0.001, Q test for heterogeneity = 0.03, P < .001, I2 = 91%).
Conclusions:
We reported a high success rate of EBD in treating pediatric SGS. The reported complications were uncommon, although they can be serious and life threatening. The intensity of SGS may be related to the likelihood of therapy failure.
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