Acquired Subglottic Stenosis in a 2-Month-Old Infant After Prolonged Intubation Associated With Pertussis Pneumonia:...

BACKGROUND Subglottic stenosis (SGS) is a life-threatening airway narrowing often acquired after prolonged intubation in infants. Although severe cases have historically required open surgery, emerging endoscopic techniques such as laser therapy, balloon dilation, and cryotherapy provide less invasive alternatives with promising outcomes. This case report describes a 2-month-old female infant who developed subglottic stenosis after intubation and mechanical ventilation for acute respiratory failure due to pertussis pneumonia. CASE REPORT A 2-month-old female infant with a history of pertussis pneumonia requiring 10 days of intubation presented with respiratory distress and stridor. Diagnostic imaging and flexible laryngoscopy confirmed grade 3 SGS (Cotton-Myer classification). She underwent a multimodal endoscopic approach, including holmium laser ablation (0.5-1.0 J/pulse) for fibrotic tissue removal, balloon dilation (6 mm, 14 atmospheres) to expand the stenotic segment, and cryotherapy (-70°C) to minimize scar formation. Immediate post-procedural improvement was observed, and oxygen was gradually tapered by day 5. Follow-up fiber laryngoscopy at 1 month demonstrated sustained airway patency without restenosis. CONCLUSIONS This case supports the efficacy of combined endoscopic modalities for severe pediatric SGS, offering advantages over open surgery, including reduced morbidity and faster recovery. Long-term studies are needed to confirm durability, particularly for high-grade stenosis. Standardized protocols for laser settings, balloon sizing, and cryotherapy duration should be established to optimize outcomes.