Etiology-based management spectrum and outcomes of pediatric central airway stenosis: a retrospective cohort study
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Published on: November 4, 2025
Li'e Zeng1, Jieru Lin1, Yuting You1
1Children's Respiratory Department, Quanzhou Maternity and Children's Hospital(Quanzhou Children's Hospital), Quanzhou, Fujian , 362000, China.
Insights
Pediatric central airway stenosis varies by cause, influencing treatment and outcomes. An etiology-based approach improves management for children with airway stenosis.
Area of Science:
- Pediatric Pulmonology
- Thoracic Surgery
- Medical Genetics
Background:
- Central airway stenosis (CAS) in children presents diverse clinical phenotypes.
- Understanding the etiological basis is crucial for effective management.
Purpose of the Study:
- To characterize pediatric CAS phenotypes.
- To analyze treatment strategies and outcomes based on etiology.
- To support individualized, etiology-oriented management.
Main Methods:
- Retrospective study of 150 pediatric CAS patients.
- Etiological classification: congenital, cardiogenic compression, dynamic, acquired.
- Comparison of clinical characteristics and management strategies across groups.
Main Results:
- Significant differences in age, severity, and location of stenosis among etiological groups.
- Treatment strategies varied significantly by etiology.
- High overall efficacy rates (80.4%-94.1%) observed across groups.
Conclusions:
- Pediatric CAS phenotype is strongly linked to etiology and treatment choice.
- An etiology-based classification guides precise, individualized treatment strategies.
- This approach is associated with favorable outcomes in pediatric CAS.
Objective:
This study aimed to describe the phenotypic characteristics, treatment strategies, and outcome spectrum of multi-factorial pediatric central airway stenosis, as well as to provide evidence for etiology-oriented individualized management of such cases.
Methods:
We conducted a retrospective study by enrolling pediatric patients with central airway stenosis. Based on etiology, they were categorized into four groups: congenital, cardiogenic compression, dynamic, and acquired. We compared baseline characteristics (age stratification, gender, Myer-Cotton classification, stenosis location, stenosis length, Clinical Respiratory Score [CRS] severity) and relevant management strategies (follow-up observation, bronchoscopic interventional therapy, surgical intervention) across different etiological groups. Resultant outcomes were classified as either cured, improved, or ineffective; effective outcomes were defined as cured or improved.
Results:
We enrolled 150 cases with a confirmed diagnosis of central airway stenosis (46 congenital, 66 cardiogenic compression, 21 dynamic, and 17 acquired). Significant differences were observed among the etiological groups regarding age stratification, Myer-Cotton classification, stenosis location, and CRS severity(p < 0.05). Treatment strategies were significantly correlated with the etiology. Acquired stenosis was primarily managed by flexible bronchoscopic intervention (94.1%), whereas cardiogenic compression stenosis and dynamic stenosis were predominantly managed with surgical intervention (69.7%) and follow-up observation (81.0%), respectively. All groups exhibited high overall efficacy rates (80.4%-94.1%); the cardiogenic compression stenosis group achieved an efficacy rate of 81.8% under surgical management.
Conclusion:
The clinical phenotype of pediatric central airway stenosis is significantly related to the etiology and treatment selection. Hence, the proposed management framework of 'etiology-based classification guiding clinical strategies' may support precise individualized treatment and is associated with favorable outcomes for such pediatric patients.
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