Balloon Dilation for Recurrent Stenosis after Pediatric Laryngotracheoplasty
| Autor: | John P. Bent, Maulik B. Shah, Sanjay R. Parikh, Ryan Nord |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Stridor Subglottic stenosis medicine.medical_treatment Catheterization 03 medical and health sciences Postoperative Complications 0302 clinical medicine Tracheotomy Recurrence medicine Humans Child 030223 otorhinolaryngology Subglottis Respiratory Sounds Retrospective Studies Croup business.industry Infant Laryngostenosis General Medicine Weather balloon medicine.disease Surgery Tracheal Stenosis Trachea Stenosis Otorhinolaryngology Child Preschool 030220 oncology & carcinogenesis Balloon dilation Female Larynx medicine.symptom business Follow-Up Studies |
| Zdroj: | Annals of Otology, Rhinology & Laryngology. 119:619-627 |
| ISSN: | 1943-572X 0003-4894 |
| Popis: | Objectives We assessed the safety and efficacy of balloon dilation as treatment for recurrent stenosis after pediatric laryngotracheoplasty. Methods We studied a retrospective case series at an academic tertiary care children's hospital. We included all patients under the age of 18 years with subglottic or tracheal stenosis treated at our institution with balloon dilation between June 2007 and April 2009. The records were analyzed for patient demographics, presenting symptoms, surgical technique, and airway description. The outcome measures were airway diameter, postoperative symptoms, tracheotomy status, and complications. Results Ten patients (9 with subglottic stenosis and 1 with tracheal stenosis) underwent 20 balloon dilation procedures without complication. The average age at the time of the procedure was 17 months (range, 3 months to 9 years). The patient presenting symptoms were stridor in 7 cases and tracheotomy in 3 cases. Vascular balloons (diameter range, 6 to 12 mm; length, 20 mm) were inflated to 10 to 12 cm H2O pressure for an average of 40 seconds (range, 10 to 120 seconds). Each procedure consisted of 1 to 3 dilation cycles. The immediate postdilation airway area increased by an average factor of 4.9 (range, 1.9 to 9). Six patients had repeat procedures with an average interval between dilations of 67 days (range, 6 to 337 days). Stridor was eliminated or greatly improved in all patients on the first postoperative day; 7 patients sustained this benefit, with an average follow-up time of 10 months (range, 4 to 23 months). Six of the 10 patients had undergone previous laryngeal reconstruction (age range, 3 months to 4 years). Of these 6, 3 have no tracheotomy, with a mean follow-up of 12.5 months. The 3 children who benefited the least from dilation were noted to have more diffuse and chronic inflammation of the larynx in comparison to the responders. Conclusions This case series suggests that balloon dilation is a relatively safe and effective procedure. It may be particularly well suited to recent stenosis after laryngotracheal reconstruction. |
| Databáze: | OpenAIRE |
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