Balloon dilation laryngoplasty for subglottic stenosis in children: eight years' experience.

OBJECTIVE To evaluate outcomes of balloon dilation laryngoplasty for laryngeal stenosis in children. DESIGN Retrospective study. SETTING Academic tertiary care department of pediatric otolaryngology. PATIENTS All children treated with laryngeal balloon dilation (primarily or secondarily following laryngeal surgery) from 2002 to 2010. MAIN OUTCOME MEASURES Stenosis severity, measured using the Cotton and Myer classification. RESULTS A total of 44 children ranging in age from 1 month to 10 years (14 [32%] with grade II stenosis, 25 [59%] with grade III stenosis, and 4 [9%] with grade IV stenosis) were included. Twelve children [27%] had congenital laryngeal stenoses, and the in other 32 [7 3%], stenosis was acquired. A total of 52 balloon dilation laryngoplasties were performed, and 37 (71%) were deemed successful. Twenty of the 31 patients undergoing primary dilation (65%) had successful outcomes, and in the other 11 [35%], outcomes were unsuccessful (4 had grade II stenosis and 7 had grade III stenosis) and required either laryngotracheal reconstruction or tracheotomy. Twenty-one balloon dilations were performed as a secondary procedure after recent open surgery; 17 of the procedures (81%) were successful, and thus surgical revision was avoided. CONCLUSION Balloon dilation laryngoplasty is an efficient and safe technique for the treatment of both primary and secondary pediatric laryngotracheal stenosis.

[1]  R. Rahbar,et al.  Minimally invasive endoscopic management of subglottic stenosis in children: success and failure. , 2011, International journal of pediatric otorhinolaryngology.

[2]  P. Serio,et al.  Endoscopic anterior cricoid split and balloon dilation in pediatric subglottic stenosis. , 2010, International journal of pediatric otorhinolaryngology.

[3]  R. Ward,et al.  A pilot study of balloon dilation in an animal model resulting in cricoid cartilage fracture: Implications for the stenotic pediatric airway , 2010, The Laryngoscope.

[4]  J. Bent,et al.  Balloon Dilation for Recurrent Stenosis after Pediatric Laryngotracheoplasty , 2010, The Annals of otology, rhinology, and laryngology.

[5]  A. Turkistani,et al.  Comparison of the outer diameter of the ‘best-fit’ endotracheal tube with MRI-measured airway diameter at the cricoid level , 2009, European Journal of Anaesthesiology.

[6]  R. Cotton,et al.  History of pediatric laryngotracheal reconstruction. , 2008, Otolaryngologic clinics of North America.

[7]  S. Sobol,et al.  Balloon laryngoplasty as a primary treatment for subglottic stenosis. , 2007, Archives of otolaryngology--head & neck surgery.

[8]  L. Devisme,et al.  Determination of Endotracheal Tube Size in a Perinatal Population: An Anatomical and Experimental Study , 2006, Anesthesiology.

[9]  M. François,et al.  Laryngotrachéoplastie avec quadrisection du cartilage cricoïde chez l’enfant , 2004 .

[10]  V. Couloigner,et al.  [Laryngotracheoplasty reconstruction with four-quadrant cricoid division in children]. , 2004, Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Societe d'oto-laryngologie des hopitaux de Paris.

[11]  M. Francois,et al.  [Surgical management of laryngeal stenosis in children]. , 1999, Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Societe d'oto-laryngologie des hopitaux de Paris.

[12]  H. Eckel,et al.  Morphology of the Human Larynx during the First Five Years of Life Studied on Whole Organ Serial Sections , 1999, The Annals of otology, rhinology, and laryngology.

[13]  P. Monnier,et al.  Partial Cricotracheal Resection for Severe Pediatric Subglottic Stenosis: Update of the Lausanne Experience , 1998, The Annals of otology, rhinology, and laryngology.

[14]  C. Myer,et al.  Proposed Grading System for Subglottic Stenosis Based on Endotracheal Tube Sizes , 1994, The Annals of otology, rhinology, and laryngology.

[15]  R. Cotton.  Pediatric laryngotracheal reconstruction , 1992 .

[16]  A. Hebra,et al.  Balloon tracheoplasty in children: results of a 15-year experience. , 1991, Journal of pediatric surgery.

[17]  S. Pransky,et al.  One-stage laryngotracheoplasty. , 1991, Archives of otolaryngology--head & neck surgery.

[18]  C. Garel,et al.  [Balloon dilatation of tracheobronchial stenoses in children. Apropos of 4 cases]. , 1991, Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Societe d'oto-laryngologie des hopitaux de Paris.

[19]  M. Francois,et al.  Surgical treatment for laryngotracheal stenosis in the pediatric patient. , 1990, Archives of Otolaryngology - Head and Neck Surgery.

[20]  A. Drake,et al.  Lateral cricoid cuts as an adjunctive measure to enlarge the stenotic subglottic airway: an anatomic study. , 1989, International journal of pediatric otorhinolaryngology.