Abstract
Objective
Often pediatric croup is viral in etiology. Children with recurrent croup (greater than 3 episodes a year) may have underlying pathology making them more prone to these episodes. This study was done to define the frequency of these pathologies.
Methods
80 consecutive children with the diagnosis of recurrent croup underwent diagnostic endoscopy at a pediatric tertiary care hospital. We carried out a retrospective chart review of these cases.
Results
Of the 80 children, 26 (33%) were found to have subglottic stenosis. The average narrowing was 32 ± 9% in these children. Of the 26 with subglottic stenosis, 19 (73%) also manifested laryngopharyngeal reflux. Of the 15 (19%) patients previously intubated as neonates or infants, 8 (53%) also had subglottic stenosis. 45 (56%) were felt to have laryngopharyngeal reflux by either laryngotracheal findings or other testing. 26 (58%) of these had concomitant subglottic stenosis. Allergies or asthma were found in 31 (39%) of the patients. Another 16 (20%) were found to have tracheomalacia and an additional 7 (9%) were noted to have innominate artery compression. Many had more than one risk factor.
Conclusions
The most common factors associated with recurrent croup are laryngopharyngeal reflux and subglottic stenosis. This study will assist the clinician in discussion of possible etiologies with families and insurers. Defining underlying pathology can then assist in the defining treatment options.
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