Balloon dilation for recurrent stenosis after pediatric laryngotracheoplasty

John P. Bent, Maulik B. Shah, Ryan Nord, Sanjay R. Parikh

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

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 followup 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 followup 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.

Original languageEnglish (US)
Pages (from-to)619-627
Number of pages9
JournalAnnals of Otology, Rhinology and Laryngology
Volume119
Issue number9
StatePublished - Sep 2010

Fingerprint

Dilatation
Pathologic Constriction
Pediatrics
Tracheotomy
Tracheal Stenosis
Respiratory Sounds
Tertiary Healthcare
Larynx
Blood Vessels
Demography
Outcome Assessment (Health Care)
Inflammation
Safety
Pressure

Keywords

  • Airway
  • Balloon
  • Dilation
  • Laryngoplasty
  • Pediatrics
  • Subglottis

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Balloon dilation for recurrent stenosis after pediatric laryngotracheoplasty. / Bent, John P.; Shah, Maulik B.; Nord, Ryan; Parikh, Sanjay R.

In: Annals of Otology, Rhinology and Laryngology, Vol. 119, No. 9, 09.2010, p. 619-627.

Research output: Contribution to journalArticle

Bent, John P. ; Shah, Maulik B. ; Nord, Ryan ; Parikh, Sanjay R. / Balloon dilation for recurrent stenosis after pediatric laryngotracheoplasty. In: Annals of Otology, Rhinology and Laryngology. 2010 ; Vol. 119, No. 9. pp. 619-627.
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