Surgery for recurrent croup? A new therapeutic tool

Viral laryngotracheobronchitis, or croup, is a common cause of emergency room visits, hospital admissions, and school absenteeism. Subglottic cauterization is an innovative surgical procedure that, using local heat, aims to adhere the subglottic mucosa to the cricoid cartilage, thereby reducing mucosal edema and, consequently, the frequency and/or severity of episodes.

To evaluate subglottic cauterization as a surgical treatment in pediatric patients diagnosed with recurrent croup that do not respond to conventional medical management.

Retrospective study of pediatric patients from the Concepción Regional Hospital with a diagnosis of recurrent croup (>2 episodes/year) who underwent subglottic cauterization between 2020 and 2024 were included, whose comorbidities (asthma, GERD, allergic rhinitis) had been previously treated.

Four patients, aged between 5 and 8 years at the time of the intervention, underwent subglottic cauterization, with an average follow-up of 23 months. Prior to surgery, they experienced an average of 7 episodes and 2.25 hospitalizations per year, figures that decreased to 2.25 episodes and no hospitalizations during follow-up. In the immediate postoperative period, none of the patients had a postoperative stay longer than 24 hours or required ICU/critical care unit admission. In the long term, none of the patients exhibited voice alterations, secondary subglottic stenosis, or any other injury or symptom associated with the surgery.

We present subglottic cauterization as an alternative for patients with recurrent croup who do not respond satisfactorily to medical treatment, as a low-morbidity surgery with excellent clinical outcomes.