Airway Endoscopy Findings in Children with Recurrent Croup

Area of Science:

• Pediatric Otolaryngology
• Pediatric Airway Disorders
• Diagnostic Endoscopy

Background:

• Recurrent croup often prompts microlaryngoscopy and bronchoscopy (MLB) to detect subglottic issues.
• The diagnostic yield of MLB in this context is variable, necessitating further investigation.
• Understanding the utility of endoscopic airway evaluation is crucial for clinical decision-making.

Purpose of the Study:

• To determine the utility of endoscopic airway evaluation in children with recurrent croup.
• To identify the incidence of positive findings that alter management or require intervention.
• To explore factors associated with abnormal findings.

Main Methods:

• Retrospective review of all microlaryngoscopy and bronchoscopies (MLB) performed for recurrent croup.
• Data collected from three pediatric otolaryngologists at a tertiary care academic children's hospital.
• Study period: January 1, 2019, to December 31, 2023.

Main Results:

• Sixty-two MLBs were performed for recurrent croup in children (mean age 4.3 years).
• Abnormal findings were present in 33.9% of patients, but only 4.8% had subglottic stenosis (grades I or II).
• Preterm birth, younger age, intubation history, and inpatient consultation were linked to abnormal MLB findings.

Conclusions:

• Microlaryngoscopy and bronchoscopy in children with recurrent croup show a low incidence of significant subglottic pathology.
• Specific patient characteristics may predict those who could benefit from surgical intervention.
• Healthcare disparities may impact referral patterns for these procedures.