Safe balloon sizing for endoscopic dilatation of subglottic stenosis in children

J Laryngol Otol. 2017 Mar;131(3):268-272. doi: 10.1017/S0022215117000081. Epub 2017 Jan 18.

Abstract

Objectives: To describe our experience and provide guidelines for maximum safe balloon sizes according to age in children undergoing balloon dilatation.

Method: A retrospective review was conducted of children undergoing balloon dilatation for subglottic stenosis in a paediatric tertiary unit between May 2006 and February 2016.

Results: A total of 166 patients underwent balloon dilatation. Mean ( ± standard deviation) patient age was 4.5 ± 3.99 years. The median balloon size was 8 mm, the median balloon inflation pressure was 10 atm, and the mean balloon inflation time was 65.1 ± 18.6 seconds. No significant unexpected events occurred. The Pearson correlation co-efficient for the relationship between patient age and balloon size was 0.85 (p = 0.001), suggesting a strongly positive correlation.

Conclusion: This study demonstrated that balloon dilatation is a safe procedure for airway stenosis. The results suggest using a balloon diameter that is equal to the outer diameter of the age-appropriate endotracheal tube +1 mm for the larynx and subglottis and +2 mm for the trachea.

Keywords: Acquired Subglottic Stenosis; Airway Management; Congenital Subglottic Stenosis; Dilatation; Tracheal Stenosis.

Publication types

  • Evaluation Study

MeSH terms

  • Catheterization / instrumentation*
  • Catheterization / methods
  • Child
  • Child, Preschool
  • Dilatation / instrumentation*
  • Dilatation / methods
  • Female
  • Humans
  • Laryngoscopy / instrumentation*
  • Laryngoscopy / methods
  • Laryngostenosis / surgery*
  • Male
  • Retrospective Studies