Abstract
Objective: 1) Report outcomes of balloon dilation in the endoscopic management of pediatric SGS. 2) Determine the role of balloon dilation in both primary vs adjuvant therapy.
Method: Retrospective review of treatment with noncompliant, high-pressure balloons for SGS in the past 2 years at a tertiary pediatric hospital. Fifty-one dilations in 28 children with SGS were performed. Mean age was 39.2 months. Mean SGS grade was 2.40.
Results: Overall, 18 (64.2%) had successful balloon treatment. Fifteen children had primary and 13 had secondary balloon dilation. Those with primary, 10 (66.6%), were able to avoid open reconstruction/tracheotomy, and 5 were temporized (36 days average) until definitive open reconstruction. Those with secondary, 9 (69.2%), were able to decannulate. Eight of 10 failed balloon dilations had concomitant airway pathologies, compared with only 6 of 12 where treatment was successful (P = .02). There was no statistical association in successful vs failed treatment by age (49.6 vs 29.3, P = .43), degree of stenosis (2.39 vs 2.60, P = .41), presence of lung disease (33.3% vs 70%, P = .07) or soft nature of stenosis (61.1% vs 40%, P = .28).
Conclusion: Balloon dilation plays an important role in the primary or adjuvant management of pediatric SGS. Presence of concomitant airway lesions is significantly associated with balloon dilation treatment failure. Meticulous surveillance of the dilated airway is necessary given this failure rate.
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