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Management of balloon dilatation in cases of subglottic stenosis in children: success and failure

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To assess efficacy and prognostic factors of endoscopic balloon dilatation for the treatment of subglottic stenosis in children.

Methods

A retrospective review was performed on 49 pediatric patients with subglottic stenosis treated at the Shanghai Children’s Hospital between December 2017 and December 2021. Specific demographic data, type and severity of the stenosis, number of balloon dilatations and outcomes were recorded and analyzed.

Results

Forty-nine children (30 male, 19 female) were included in the study with a median age at diagnosis of 24 (13–36.5) months, of which 7 (14.3%) had received open laryngotracheal reconstruction previously. The degree of subglottic stenosis was grade I in six patients, grade II in 16 patients, grade III in 20 patients and grade IV in seven patients. After various numbers of balloon dilatations (1–7 times), 29 patients showed a good outcome (decannulation or prevention of tracheostomy) and the success rate in that series was 59.2%. Overall, prognosis of balloon dilatation was not dependent on pathogeny (congenital or acquired) or open surgical history(P > 0.05), but rather on the severity grade of stenosis and the number of dilatations (P < 0.05).

Conclusions

Endoscopic balloon dilatation can be safe and effective in the treatment of subglottic stenosis in children, except for more serious cases (grade IV). Open surgery should be considered if no significant improvement is observed after dilatation, especially after three or more dilatations.

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Availability of data and materials

The data supporting the results reported in the manuscript are available from the corresponding author upon reasonable request.

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Acknowledgements

We are very grateful to all members of Department of Otolaryngology-Head and Neck Surgery, Shanghai Children’s Hospital, School of medicine, Shanghai Jiao Tong University.

Funding

The study was supported by Shanghai Shen-kang Hospital Development Centre (No: SHDC12019X21).

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Shanghai Children’s Hospital, Shanghai Jiao Tong University, No. 24, Lane 1400, West Beijing Road, Shanghai, 200040, People’s Republic of China

    Yangyang Zheng, Hongming Xu & Xiaoyan Li

Authors
  1. Yangyang Zheng
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  2. Hongming Xu
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  3. Xiaoyan Li
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Contributions

YZ: conceptualization, methodology, software, validation, formal analysis, data curation, writing—original draft. HX: methodology, validation, formal analysis. XL: conceptualization, methodology, validation, writing—review and editing, funding acquisition. Each of the authors has contributed to and approved the final version of this manuscript.

Corresponding author

Correspondence to Xiaoyan Li.

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Conflict of interest

The authors declare that there is no conflict of interest regarding the publication of this paper.

Ethical approval

Approval was obtained from the ethics committee of Shanghai Children’s Hospital. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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

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Zheng, Y., Xu, H. & Li, X. Management of balloon dilatation in cases of subglottic stenosis in children: success and failure. Eur Arch Otorhinolaryngol 280, 2859–2864 (2023). https://doi.org/10.1007/s00405-023-07826-z

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  • DOI: https://doi.org/10.1007/s00405-023-07826-z

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