title: Outcomes of balloon dilation in pediatric subglottic stenosis.
abstract: OBJECTIVE
  We report outcomes of balloon dilation in the endoscopic management of pediatric subglottic stenosis (SGS) and discuss the role of balloon dilation in both primary and adjuvant therapy.
  
  
  METHODS
  We performed a retrospective review of treatment with noncompliant, high-pressure balloons for SGS in the past 2 years at a tertiary pediatric hospital. Fifty-one dilations were performed in 28 children with SGS. The children's mean age was 42 months. The mean SGS grade was 2.46.
  
  
  RESULTS
  Fifteen children had primary balloon dilation, and 13 had adjuvant balloon dilation. Overall, 16 children (57.1%) had successful balloon dilation. Of those who underwent primary dilation, 9 (60.0%) were able to avoid open reconstruction or tracheotomy and 6 had their symptoms temporarily improved (average, 36 days) until definitive open reconstruction. Of the patients who underwent adjuvant dilation, 7 (53.8%) were successfully decannulated. Nine of the 12 failed balloon dilations were in children who had concomitant airway disorders; in contrast, only 6 of 16 children in whom treatment was successful had concomitant airway disorders (p = 0.048). There was no statistical association between successful versus failed treatment and age (51.6 versus 27.9 months; p = 0.23), degree of stenosis (grade 2.3 versus grade 2.6; p = 0.41), presence of lung disease (33.3% versus 70%; p = 0.07), or soft versus firm stenosis (60.0% versus 53.1%; p = 0.71).
  
  
  CONCLUSIONS
  Balloon dilation plays an important role in the primary and adjuvant management of pediatric SGS. The presence of concomitant airway lesions is significantly associated with failure of balloon dilation treatment. Meticulous surveillance of the dilated airway is necessary, given this failure rate.
authors: Division of Otolaryngology, Children's National Medical Center, George Washington University School of Medicine, Washington, DC 20010, USA.
authors: Amy S
authors: AS
authors: Whigham
authors: Rebecca
authors: R
authors: Howell
authors: Sukgi
authors: S
authors: Choi
authors: Maria
authors: M
authors: Peña
authors: George
authors: G
authors: Zalzal
authors: Diego
authors: D
authors: Preciado
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology / Q000628:therapy; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007828:Laryngoscopy; D007829:Laryngostenosis / Q000150:complications / Q000628:therapy*; D008297:Male; D012140:Respiratory Tract Diseases / Q000150:complications; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome