Effect of balloon dilation tracheoplasty in the management of acquired subglottic stenosis in children

Abstract

Objective:To assess the efficiency and safety of balloon dilation tracheoplasty technique in the management of acquired subglottic stenosis in children. Method:Twenty-three cases were diagnosed as acquired subglottic stenosis by chest CT scan and bronchoscpy，and received the treatment of the balloon dilatation tracheoplasty.The data about the efficiency，complication and prognosis of the treatment were collected. Result:In the 23 cases，6 of All 11 patients with tracheotomy were decannulated,11 patients were successfully managed without tracheotomy，1 patients received laryngotracheal reconstruction(LTR) surgery, 5 cases were still under observation. The overall response rate was 73.91%.All cases were divided into three stages according to Cotton stage system:1 cases were stage Ⅰ stenosis，6 cases were stage Ⅱ and 16 cases were stage Ⅲ. The response rate was 100.00%，83.33%，and 68.75% respectively. The most common complication in the balloon dilatation tracheoplasty was restenosis. Restenosis occurs in 12（52.17%） cases who received more than 1 dilation procedures in this study. Over all average dilation times is 1.87. Eight cases(88.9%) of 9 in fresh leision group were recoverd, the average dilation time is 1.22; 8 cases (57.14%) of 14 in old leision group were recoverd, the average dilation time is 2.23. The average dilation time between two group is significant(P<0.05). Conclusion:Subglottic stenosis in pediatric patients can be successfully managed with balloon dilation tracheoplasty. In patients without prior tracheotomy, tracheotomy can often be safely avoided with appropriate postoperative management.