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Impact of balloon laryngoplasty on management of acute subglottic stenosis

  • Andréia Melchiors Wenzel
  • Cláudia Schweiger
  • Denise Manica
  • Leo Sekine
  • Isabel Cristina Schütz Ferreira
  • Gabriel Kuhl
  • Paulo José Cauduro Marostica
Laryngology

Abstract

Purpose

To assess the impact of balloon laryngoplasty on clinical and surgical outcomes in pediatric patients with acute subglottic stenosis.

Methods

Two case series were included and compared. The first group included patients treated initially either with tracheostomy (if severe symptoms) or with close follow-up (if mild symptoms). Those children underwent re-evaluation and specific treatment of their stenosis with laser incisions or open surgeries some weeks later. The other group included children treated initially with balloon laryngoplasty, reflecting a shift in surgical practice after 2009. Data as success of the procedure, mean hospital stay, mean pediatric intensive care unit (PICU) stay, post-procedure fever, need of antibiotics, procedure-related complications, and deaths were assessed and compared between both cohorts.

Results

The sample comprised 38 pediatric patients aged 0–5 years. Fifteen children were treated before 2009, of who 10 (66.7%) required tracheostomy soon after the diagnosis. Ultimately, 13 (86.6%) underwent laryngotracheal reconstruction. Twenty-three children were treated after 2009 and the success rate in these patients treated primarily with balloon laryngoplasty was 82.6%. Of these, only 3 (13%) required tracheostomy and 1 (4.3%) required further open laryngotracheal reconstruction. Patients treated by balloon laryngoplasty underwent fewer procedures under general anesthesia and had a lower burden of treatment-related morbidity, as denoted by shorter PICU stay, less antibiotic use, earlier postoperative resumption of oral feeding, and a lower incidence of postoperative complications and fever.

Conclusion

When used for management of acute laryngeal stenosis, balloon laryngoplasty is associated with a high success rate, presenting lower morbidity than open surgery.

Keywords

Balloon laryngoplasty Subglottic stenosis Morbidity Treatment 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Andréia Melchiors Wenzel
    • 1
  • Cláudia Schweiger
    • 1
    • 2
  • Denise Manica
    • 1
    • 2
  • Leo Sekine
    • 3
  • Isabel Cristina Schütz Ferreira
    • 1
    • 4
  • Gabriel Kuhl
    • 2
  • Paulo José Cauduro Marostica
    • 1
    • 5
  1. 1.Programa de Pós-Graduação em Saúde da Criança e do AdolescenteUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
  2. 2.Otolaryngology and Head and Neck Surgery DepartmentHospital de Clínicas de Porto AlegrePorto AlegreBrazil
  3. 3.Programa de Pós-Graduação em EpidemiologiaUniversidade Federal do Rio Grande do Sul (UFRGS)Porto AlegreBrazil
  4. 4.Pediatric DepartmentHospital de Clínicas de Porto AlegrePorto AlegreBrazil
  5. 5.Pediatric Pulmonology DepartmentHospital de Clínicas de Porto AlegrePorto AlegreBrazil

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