Endoscopic management of subglottic stenosis.

OBJECTIVES

Determine the effectiveness of endoscopic surgical treatment of subglottic stenosis (SGS) in children as a primary surgical modality to prevent laryngotracheal reconstruction (LTR) and as treatment for restenosis following primary LTR to prevent revision LTR.

PATIENTS: Children undergoing various endoscopic surgical treatments from 1989 to 2006 for SGS.

RESULTS

The number of children and success rates per grade of SGS and the number of procedures required to produce a successful result in 29 children initially managed endoscopically included grade I, three of three (100%), 1.3 procedures; grade II, eight of nine (88%), 2.6 procedures; and grade III, 13 of 17 (76%), 3.5 procedures. Of 102 patients undergoing open LTR, 56 of 102 required endoscopic interventions and 41 of 56 (73%) children were treated successfully.

CONCLUSION

Endoscopic intervention can be used to manage SGS either as a primary intervention or to treat reobstruction and restenosis following an open reconstructive procedure. Success rates decline as the severity of stenosis increases.