Aerodigestive Approach in Evaluating Pediatric Patients With Recurrent Croup

To evaluate the effectiveness of coordinated endoscopy with otolaryngology, pulmonology, and gastroenterology in diagnosing and managing recurrent croup in pediatric patients.

We reviewed our REDCap Pediatric Aerodigestive Database for patients with recurrent croup who underwent coordinated endoscopy between January 2013 and July 2023. We reviewed patient demographics, comorbidities, surgical findings, treatments, and outcomes.

Twenty-five patients were identified with recurrent croup. Their mean (SD) age was 37 (27) months (range = 9-98 months) with half of the patients younger than 25 months. The most common findings noted on combined endoscopies were positive bacterial culture on BAL (n = 10), and tracheomalacia (n = 7), and subglottic stenosis (n = 4). A history of prematurity was significantly associated with the presence of SGS (p = 0.01). Snoring/sleep-disordered breathing (SDB) was associated with a positive bacterial BAL culture (p = 0.03). About half of our cohort (48%) had multiple abnormalities identified by at least 2 different specialists at the time of endoscopy.

For patients experiencing frequent or severe recurrent croup episodes, a thorough aerodigestive evaluation and management plan should be pursued. Coordinated endoscopy may be considered for select patients who do not respond to medical treatment.