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European Archives of Oto-Rhino-Laryngology

, Volume 275, Issue 10, pp 2529–2533 | Cite as

Rigid dilatation of pediatric laryngotracheal stenosis as an adequate alternative to balloon dilatation

  • Daniel Yafit
  • Oren Cavel
  • Omer J. Ungar
  • Oshri Wasserzug
  • Yael Oestreicher-Kedem
  • Anna Shklovsky-Kordi
  • Ari DeRowe
Laryngology
  • 50 Downloads

Abstract

Introduction

Endoscopic balloon dilation (EBD) is the mainstay of endoscopic therapy for laryngotracheal stenosis (LTS), although there is no evidence that it achieves better results than traditional rigid laryngeal dilators. Rigid bougie dilators are less expensive and easier to use, and confer the advantage of providing tactile information about the stenosis to the surgeon. We analyzed the outcome of endoscopic rigid bougie dilatation of LTS in a large series of children and compared it to the reported results of EBD in the same setting.

Patients and methods

All cases of pediatric LTS treated by endoscopic rigid dilatation in a tertiary referral center between 2006 and 2015 were retrospectively studied. They were divided into a primary dilatation group (PDG) and a post-reconstruction dilatation group (PRG). The PDG children had no history of reconstructive airway surgery, and dilatation was the major treatment approach. The PRG children underwent dilatations after airway reconstruction surgery as part of routine postoperative management. A successful primary outcome was defined as improvement of dyspnea and achievement of a functional airway without reconstructive laryngotracheal surgery or need for a tracheostomy at final follow-up.

Results

Sixty-two children (68 cases, mean age 5.1 years, range 0.7–17.2) underwent 156 endoscopic rigid dilatations. Successful outcome was achieved in 48 cases (70.6%), 73.0% in the PDG and 67.7% in the PRG. There were no procedure-related adverse events.

Conclusions

Endoscopic rigid dilatation is a relatively inexpensive and efficacious tool in endoscopic management of pediatric LTS. Its success rates are in the same range as those of EBD.

Keywords

Laryngotracheal stenosis (LTS) Subglottic stenosis Dilatation Pediatric airway surgery Endoscopic 

Notes

Acknowledgements

Esther Eshkol is thanked for editorial assistance.

Funding

None. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Copyright information

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

Authors and Affiliations

  1. 1.Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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