The use of balloon dilation in pediatric subglottic stenosis, experience at Queen Rania Al-Abdullah Hospital for Children

الملخص EN

Objective: To evaluate the outcomes of balloon dilation and Mitomycein-C application in the endoscopic management of pediatric patients with subglottic stenosis (SGS).

Methods: A total number of 32 children 18 boys, 14 girls, age 1-7 years.

20 children (12 boys, 8 girls) had primary acute subglottic stenosis after intubation for 1-6 days (group (1).

12children (6 boys, 6 girls) had recurrent subglottic stenosis post intubation group (2).

All children in this group had been treated multiple times previously with bronchoscopic dilation without response.

22 children (13 boys, 9 girls) had moderate to severe SGS.10 children (5 girls, 5 boys) had mild to moderate SGS.

All children (groups (1) + (2) were treated with appropriate width cardiac vessel Balloon dilators endoscopically using apnoic technique without intubation.

Mitomycin-C was applied in all patients post dilation.

Results: Group (1) who had primary balloon dilation with Mitomycin-C application, 14 children (70%) had successful balloon dilation and they did not necessitate further sessions of dilation and their SGS was cured, 4 children (20%) necessitate two sessions of dilation with 3&5 weeks interval.

Two children (10%) necessitates 3 sessions of dilation, 2 weeks and 8 weeks after the first dilation to get their SGS nearly cured.

In all sessions we used Mitomycin-C application after dilation.

Group (2) who had been treated previously with bronchoscopic dilation.

12 of 12(100%) had at least 4 sessions of balloon dilations and Mitomycin-C application, with 3-4 weeks intervals and all of them after 2 years of follow up still have a some degree of SGS that is not severely symptomatic.