Subglottic stenosis in children: management and experience over 15 years at a tertiary center

Objective: To evaluate the management and outcomes of children with subglottic stenosis (SGS) at a pediatric tertiary center over 15 years. Methods: The analysis included all the patients diagnosed with SGS during 2004 through 2018. Data were analyzed for age, sex, grade of stenosis, numbers and types of intervention, tracheostomy, comorbidities, follow-up, complications, and treatment outcomes. Results: In this period, we treated 16 children (2 girls and 14 boys) with SGS, seven with acute SGS and nine with chronic SGS. Evaluated on the Myer-Cotton scale, nine (56%) patients had grade I, two (13%) had grade II, four (25%) had grade III, and one (6%) had grade IV SGS. Tracheostomy was performed in 13 (81%) patients. Microlaryngoscopy was performed a median nine times in patients with acute SGS and seven times in patients with chronic SGS. Eight of the 16 patients underwent successful decannulation, two patients have a tracheostomy to this time, and two patients died. Conclusion: We observed no patients with congenital SGS. We observed no statistically significant differences in the numbers of laryngoscopies, dilatations, and endotracheal intubations between patients with acute and chronic SGS. We observed no statistically significant relationship between the grade of stenosis and length of intubation. We observed no statistically significant difference between patients with acute and chronic SGS in the length of therapy. Early microlaryngoscopy with dilatation of stenosis using either bougie or balloon appears to be effective.