Surgery for recurrent croup? A new therapeutic tool

Area of Science:

• Otolaryngology
• Pediatric Surgery

Background:

• Recurrent croup (viral laryngotracheobronchitis) is a frequent cause of pediatric emergency visits and school absenteeism.
• Conventional medical management often fails to adequately address severe or persistent croup cases.

Purpose of the Study:

• To assess the efficacy and safety of subglottic cauterization as a surgical intervention for pediatric recurrent croup.
• To evaluate outcomes in patients refractory to standard medical treatments.

Main Methods:

• Retrospective analysis of pediatric patients diagnosed with recurrent croup (>2 episodes/year) treated between 2020-2024.
• Inclusion criteria required prior treatment of comorbidities like asthma, GERD, and allergic rhinitis.
• Subglottic cauterization was performed using local heat to adhere mucosa to the cricoid cartilage.

Main Results:

• Four patients (ages 5-8) underwent the procedure with a mean follow-up of 23 months.
• Pre-surgery: average 7 episodes and 2.25 hospitalizations/year. Post-surgery: average 2.25 episodes and 0 hospitalizations/year.
• No patients required extended postoperative stays, ICU admission, or experienced long-term voice alterations or stenosis.

Conclusions:

• Subglottic cauterization offers a viable surgical alternative for recurrent croup cases unresponsive to medical therapy.
• The procedure demonstrates low morbidity and excellent clinical results in pediatric patients.
• This innovative technique effectively reduces symptom frequency and severity, improving patient quality of life.