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BioMed Research International
Volume 2014 (2014), Article ID 397295, 4 pages
http://dx.doi.org/10.1155/2014/397295
Research Article

Balloon Dilatation of Pediatric Subglottic Laryngeal Stenosis during the Artificial Apneic Pause: Experience in 5 Children

1Department of Imaging Methods, 2nd Medical Faculty, University Hospital Motol, Charles University, 150 06 Prague, Czech Republic
2Children ENT Department, 2nd Medical Faculty, University Hospital Motol, Charles University, 150 06 Prague, Czech Republic
3Department of Otorhinolaryngology and Head and Neck Surgery, 1st Medical Faculty, University Hospital Motol, Charles University, 150 06 Prague, Czech Republic
4Department of Anesthesiology, 2nd Medical Faculty, University Hospital Motol, Charles University, 150 06 Prague, Czech Republic

Received 7 February 2014; Revised 28 April 2014; Accepted 26 May 2014; Published 12 June 2014

Academic Editor: Jan Plzak

Copyright © 2014 J. Lisý et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Balloon dilatation is a method of choice for treatment of laryngeal stenosis in children. The aim of procedure in apneic pause is to avoid new insertion of tracheostomy cannula. Patients and Methods. The authors performed balloon dilatation of subglottic laryngeal strictures (SGS) in 5 children (3 girls and 2 boys) without tracheotomy. Two of them with traumatic and inflammatory SGS had a tracheal cannula removed in the past. The other 3 children with postintubation SGS had never had a tracheostomy before. The need for tracheostomy due to worsening stridor was imminent for all of them. Results. The total of seven laryngeal dilatations by balloon esophagoplasty catheter in apneic pause was performed in the 5 children. The procedure averted the need for tracheostomy placement in 4 of them (80%). Failure of dilatation in girl with traumatic stenosis and concomitant severe obstructive lung disease led to repeated tracheostomy. Conclusion. Balloon dilatation of laryngeal stricture could be done in the absence of tracheostomy in apneic pause. Dilatation averted threatening tracheostomy in all except one case. Early complication after the procedure seems to be a negative prognostic factor for the outcome of balloon dilatation.