Tags

Type your tag names separated by a space and hit enter

Balloon dilation in the management of severe airway stenosis in children and adolescents.
J Pediatr Surg 2013; 48(8):1676-81JP

Abstract

BACKGROUND/PURPOSE

Children and adolescents with airway stenosis pose a clinical challenge. Recently, balloon dilation has been described, primarily for the treatment of early, immature, less severe airway stenosis. We describe our experience with 8 children and adolescents managed with balloon dilation, including severe, mature subglottic and tracheal stenosis.

METHODS

This is a case series of 8 children and adolescents with acquired subglottic and tracheal stenosis treated by the primary author with balloon dilation between August 2006 and April 2010 at an academic tertiary care center. In the four patients who were tracheotomy-dependent at the time of presentation, suprastomal stents or Montgomery T-tubes were used. In 1 patient with 99% subglottic stenosis (SGS), balloon dilation and stenting were used to create a lumen prior to laryngotracheal reconstruction (LTR).

RESULTS

All 4 patients with tracheotomy were decannulated. The remaining 4 patients were successfully managed without tracheotomy.

CONCLUSIONS

Mature, severe laryngeal and tracheal stenosis in pediatric patients can be successfully managed with balloon dilation. In the most severe cases with prior tracheotomy, stenting is necessary. Balloon dilation with stenting can also facilitate LTR. In patients without prior tracheotomy, tracheotomy and stenting can often be safely avoided with appropriate postoperative management.

Authors+Show Affiliations

Department of Otolaryngology-Head and Neck Surgery, Ochsner Clinic Foundation, New Orleans, LA 70121, USA. lguarisco@ochsner.orgNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23932606

Citation

Guarisco, J Lindhe, and Christina J. Yang. "Balloon Dilation in the Management of Severe Airway Stenosis in Children and Adolescents." Journal of Pediatric Surgery, vol. 48, no. 8, 2013, pp. 1676-81.
Guarisco JL, Yang CJ. Balloon dilation in the management of severe airway stenosis in children and adolescents. J Pediatr Surg. 2013;48(8):1676-81.
Guarisco, J. L., & Yang, C. J. (2013). Balloon dilation in the management of severe airway stenosis in children and adolescents. Journal of Pediatric Surgery, 48(8), pp. 1676-81. doi:10.1016/j.jpedsurg.2012.12.035.
Guarisco JL, Yang CJ. Balloon Dilation in the Management of Severe Airway Stenosis in Children and Adolescents. J Pediatr Surg. 2013;48(8):1676-81. PubMed PMID: 23932606.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Balloon dilation in the management of severe airway stenosis in children and adolescents. AU - Guarisco,J Lindhe, AU - Yang,Christina J, PY - 2012/08/12/received PY - 2012/12/14/revised PY - 2012/12/18/accepted PY - 2013/8/13/entrez PY - 2013/8/13/pubmed PY - 2014/4/15/medline KW - Balloon dilation KW - Subglottic stenosis KW - Tracheal stenosis SP - 1676 EP - 81 JF - Journal of pediatric surgery JO - J. Pediatr. Surg. VL - 48 IS - 8 N2 - BACKGROUND/PURPOSE: Children and adolescents with airway stenosis pose a clinical challenge. Recently, balloon dilation has been described, primarily for the treatment of early, immature, less severe airway stenosis. We describe our experience with 8 children and adolescents managed with balloon dilation, including severe, mature subglottic and tracheal stenosis. METHODS: This is a case series of 8 children and adolescents with acquired subglottic and tracheal stenosis treated by the primary author with balloon dilation between August 2006 and April 2010 at an academic tertiary care center. In the four patients who were tracheotomy-dependent at the time of presentation, suprastomal stents or Montgomery T-tubes were used. In 1 patient with 99% subglottic stenosis (SGS), balloon dilation and stenting were used to create a lumen prior to laryngotracheal reconstruction (LTR). RESULTS: All 4 patients with tracheotomy were decannulated. The remaining 4 patients were successfully managed without tracheotomy. CONCLUSIONS: Mature, severe laryngeal and tracheal stenosis in pediatric patients can be successfully managed with balloon dilation. In the most severe cases with prior tracheotomy, stenting is necessary. Balloon dilation with stenting can also facilitate LTR. In patients without prior tracheotomy, tracheotomy and stenting can often be safely avoided with appropriate postoperative management. SN - 1531-5037 UR - https://www.unboundmedicine.com/medline/citation/23932606/Balloon_dilation_in_the_management_of_severe_airway_stenosis_in_children_and_adolescents_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(12)01063-9 DB - PRIME DP - Unbound Medicine ER -