title: Endolaryngeal dilatation versus laryngotracheal reconstruction in the primary management of subglottic stenosis.
abstract: OBJECTIVE
  The scope of the study is to compare endolaryngeal dilatations (ED) with laryngotracheal reconstruction with cartilage grafting (LTRCG) in terms of restenosis.
  
  
  METHODS
  Pediatric subglottic stenosis patients treated in Hacettepe University, between 2002 and 2012 were retrospectively evaluated. Patients who had ED or LTRCG as primary management were included in the study. EDs were grouped into bronchoscopic dilatation (BD), laser incision and balloon dilatation (LBD) and cold knife incision and balloon dilatation (CKBD). The groups were evaluated in terms of restenosis and decannulation rates.
  
  
  RESULTS
  There were 35 patients (9 females, 26 males; mean age 4.42). LTRCG was performed in 16 patients (9 anterior and 7 anterior and posterior grafts). EDs were performed in 19 patients with 6 CKBDs, 7 LBDs and 6 BDs. There were 3 grade II, 13 grade III cases in the LTRCG group while 4 grade I, 6 grade II, 8 grade 3 and 1 grade 4 in the ED group. Overall decannulation rate was 97% (34/35) in all patients. Restenosis was higher in the ED group (63.2%) than the LTRCG group (31.3%) with rates of CKBD 16.7% (1/6), LBD 71.4% (5/7) and BD 100% (6/6). Restenosis rates were found to be increasing with higher grades (grade I-25%, grade II-66%, grade III-85%).
  
  
  CONCLUSIONS
  ED may need more repetitive interventions than LTRCG due to restenosis. Less restenosis might be observed when balloon is used for dilatation and cold knife for mucosal incisions.
authors: Hacettepe University, Faculty of Medicine, Otolaryngology Department, Ankara, Turkey. Electronic address: rogunaydin@gmail.com.
authors: Rıza Önder
authors: RÖ
authors: Günaydın
authors: Hacettepe University, Faculty of Medicine, Otolaryngology Department, Ankara, Turkey. Electronic address: nildasuslu@yahoo.com.
authors: Nilda
authors: N
authors: Süslü
authors: Hacettepe University, Faculty of Medicine, Otolaryngology Department, Ankara, Turkey. Electronic address: demirbajin@hacettepe.edu.tr.
authors: Münir Demir
authors: MD
authors: Bajin
authors: Hacettepe University, Faculty of Medicine, Otolaryngology Department, Ankara, Turkey. Electronic address: drkuscu@gmail.com.
authors: Oguz
authors: O
authors: Kuscu
authors: Hacettepe University, Faculty of Medicine, Otolaryngology Department, Ankara, Turkey. Electronic address: tyilmaz@hacettepe.edu.tr.
authors: Taner
authors: T
authors: Yılmaz
authors: Acıbadem University, Faculty of Medicine, Otolaryngology Department, Ankara, Turkey. Electronic address: ofunal@tr.net.
authors: Ömer Faruk
authors: ÖF
authors: Ünal
authors: Hacettepe University, Faculty of Medicine, Otolaryngology Department, Ankara, Turkey. Electronic address: umutakyol@yahoo.com.
authors: Umut
authors: U
authors: Akyol
mesh_terms: D000293:Adolescent; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D003413:Cricoid Cartilage / Q000601:surgery; D003452:Cryosurgery; D004106:Dilatation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007820:Laryngeal Mucosa / Q000601:surgery; D007829:Laryngostenosis / Q000145:classification / Q000628:therapy*; D053685:Laser Therapy; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014135:Tracheal Stenosis / Q000145:classification / Q000628:therapy*
keywords: Dilatation; Endolaryngeal; Laryngotracheal reconstruction; Laryngotracheal stenosis; Laser