Upper airway complications of junctional epidermolysis bullosa

J Pediatr. 2012 Apr;160(4):657-661.e1. doi: 10.1016/j.jpeds.2011.09.029. Epub 2011 Nov 3.

Abstract

Objective: To assess the incidence of upper airway pathology in patients with junctional epidermolysis bullosa (JEB).

Study design: We conducted a retrospective chart review of all patients with JEB who came to an interdisciplinary epidermolysis bullosa center at a tertiary care institution between 2004 and 2010.

Results: Twenty-five patients with JEB were identified, and 12 patients were seen in the otolaryngology clinic (age range, 2 months-15 years; 8 male, 4 female). Of the 12 patients, 8 underwent rigid laryngoscopy and bronchoscopy for upper respiratory tract symptoms; 7 of these patients displayed laryngeal pathology, and 5 of them underwent surgical intervention with successful resolution of symptoms. Furthermore, none of these patients had any short- or long-term complications from their surgery. A strict protocol and a precise problem-focused cold surgical technique were used in these cases to protect skin and mucus membranes.

Conclusion: With appropriate precautions, endoscopic laryngeal surgery can be safe and effective in patients with JEB and larygnotracheal disease. Endoscopic laryngeal surgery is feasible when indicated for these patients.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Epidermolysis Bullosa, Junctional / complications*
  • Female
  • Humans
  • Infant
  • Laryngeal Diseases / etiology*
  • Laryngeal Diseases / therapy
  • Laryngoscopy
  • Male
  • Retrospective Studies
  • Tracheal Diseases / etiology*
  • Tracheal Diseases / therapy