Predicting outcomes of balloon laryngoplasty in children with subglottic stenosis

Avelino, Melissa; Maunsell, Rebecca; Wastowski, Isabela Jubé

doi:10.1016/j.ijporl.2015.01.022

Cited by 43 publications

(24 citation statements)

References 25 publications

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“…After review of the full-length articles, 14 were excluded, due to its use for chronic stenoses (15,(17)(18)(19)(20), due to its lack of differentiation between acute or chronic stenosis (16,19,(21)(22)(23)(24)(25)(26)(27), and/or because the paper did not differentiate between rigid or balloon dilations (27,28). The 10 remaining papers were selected for this review (3,(29)(30)(31)(32)(33)(34)(35)(36)(37).…”

Section: Endoscopic Balloon Dilation (Ebd)mentioning

confidence: 99%

“…Some authors used the INSPIRA AIRTM balloon (Acclarent Inc., CA, U.S.A.) (33,37). Other authors do not mention the brands of their balloons and/or use many different brands (3,(29)(30)(31)(32)(34)(35)(36). The balloon size was selected according to the ideal subglottic diameter for the patient's age (3, 29, 32-34, 36, 37).…”

Section: Techniquementioning

confidence: 99%

“…Other authors specifically mentioned pressures between 2 and 15 atm, (3) 2 atm, (29,31,34), 4 atm, (32), 7 atm (30). The balloon was maintained inflated for 30-60 s or until the patient's oxygen saturation level dropped below 90-92% (3,(29)(30)(31)(32)(33)(34)(35)(36)(37). Some authors repeated the procedure 2-3 times during each session (31)(32)(33)(34)(35)(36)(37).…”

Section: Techniquementioning

confidence: 99%

“…The 10 case reports and series (nine retrospectives, one prospective), published between 2007 and 2017, included 109 pediatric patients who underwent 1-6 dilations each, with an average 1.8 dilations per patient. Follow-up ranged from 5 days to 7 years (3,(29)(30)(31)(32)(33)(34)(35)(36)(37). Included studies are summarized on Table 3.…”

Section: Outcomes Of Balloon Dilationmentioning

confidence: 99%

“…Definition of acute lesions comprises those identified in <30 days since extubation (3,4). Moderate to severe lesions pose the highest probability of progressing to chronic stenosis.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Ongoing Laryngeal Stenosis: Conservative Management and Alternatives to Tracheostomy

Schweiger¹,

Manica²

2020

Front. Pediatr.

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Section: Endoscopic Balloon Dilation (Ebd)mentioning

confidence: 99%

Section: Techniquementioning

confidence: 99%

Section: Techniquementioning

confidence: 99%

Section: Outcomes Of Balloon Dilationmentioning

confidence: 99%

“…Definition of acute lesions comprises those identified in <30 days since extubation (3,4). Moderate to severe lesions pose the highest probability of progressing to chronic stenosis.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ongoing Laryngeal Stenosis: Conservative Management and Alternatives to Tracheostomy

Schweiger¹,

Manica²

2020

Front. Pediatr.

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Establishing an Endoscopic Chronic Subglottic Stenosis Rabbit Model

et al. 2021

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Objectives/Hypothesis To develop a reproducible and consistent chronic subglottic stenosis (SGS) in an endoscopic animal model. Study Design Prospective study. Methods We conducted a prospective study using New Zealand white rabbits. Chronic SGS was induced endoscopically by Bugbee electrocautery to 50% to 75% of the subglottic area's circumference, followed by 4‐hour endotracheal intubation. The rabbit airways were endoscopically assessed and sized with uncuffed endotracheal tubes (ETTs) before the injury, during follow‐up, and at the endpoints. There were four endpoints: 2, 4, 6, and 8 weeks post SGS induction. Animals were humanely euthanized for histopathological examination of the subglottic injury site and microscopic measurement of the cricoid lumen. Results Twenty‐two rabbits reached the endpoints, and 18 rabbits developed chronic SGS. ETT size significantly decreased by 0.5 from preinjury to the endpoint in all groups, P < .001. Control median cricoid lumen measurements were 20.48 mm2, the median cricoid lumen measurement for the 2 weeks endpoint was 14.3 mm2, 4 weeks 11.69 mm2, 6 weeks 16.03 mm2, and 8 weeks endpoint median was 16.33 mm2. Histopathological examination showed chronic scar tissue and new cartilage formation at the cricoid level, mainly at the posterior subglottic injury site starting from 4 weeks postinjury. Collagen staining revealed substantial amounts of organized collagen and different collagen orientation starting 4 weeks postinjury lasting until 8 weeks postinjury. Conclusion We developed an animal model to study chronic SGS. This model will be utilized to compare different endoscopic treatment interventions in acute SGS versus chronic SGS and further define the molecular basis of SGS. Level of Evidence NA Laryngoscope, 132:1909–1915, 2022

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Effective treatment of post‐intubation subglottic stenosis in children with holmium laser therapy and cryotherapy via flexible bronchoscopy

Jiao

Liu

Lerner

et al. 2019

Pediatric Investigation

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Importance Post‐intubation subglottic stenosis (SGS) in children can be life threatening. Definitive treatment varies and lacks a universally accepted approach. Objective We performed a prospective study to assess the safety and feasibility of holmium laser combined with cryotherapy delivered via flexible bronchoscopy for the treatment of post‐intubation SGS in children. Methods This study involved all patients with post‐intubation SGS seen at the Interventional Pulmonology Department of Beijing Children's Hospital between July 2014 and December 2016. Holmium laser treatment and cryotherapy was then performed under flexible bronchoscopy, whose parents refused to accept the alternative standard treatment of tracheotomy and balloon dilation under direct laryngoscopy. Results Sixteen patients with post‐intubation SGS were included in this study. Ages ranged from 2 months to 12.25 years old. According to the Cotton‐Myer grading system, three cases were Grade II, 12 cases were Grade III, and one case was Grade IV. According to the McCaffrey system, eight cases were Stage 1, two cases were Stage 2, and six cases were Stage 3. The average number of procedures was 4.88. Fifteen of the 16 patients achieved clinical cure. One patient achieved clinical improvement. The average treatment course duration was 55.31 days. No severe complications were seen. Post‐treatment clinical symptoms, endoscopic findings and quality of life showed marked improvement. Interpretation Our study supports the conclusion that holmium laser treatment combined with cryotherapy via flexible bronchoscopy appears to be a safe and feasible treatment for post‐intubation SGS in children.

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Predicting outcomes of balloon laryngoplasty in children with subglottic stenosis

Cited by 43 publications

References 25 publications

Ongoing Laryngeal Stenosis: Conservative Management and Alternatives to Tracheostomy

Ongoing Laryngeal Stenosis: Conservative Management and Alternatives to Tracheostomy

Establishing an Endoscopic Chronic Subglottic Stenosis Rabbit Model

Effective treatment of post‐intubation subglottic stenosis in children with holmium laser therapy and cryotherapy via flexible bronchoscopy

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