Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics (대한후두음성언어의학회지)

The Korean Society of Laryngology, Phoniatrics and Logopedics. (대한후두음성언어의학회)
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Risk Factor Analysis of Endoscopic Dilation Procedure for the Management of Subglottic Stenosis in Pediatric Patients

성문하 협착 소아 환자에 대한 내시경적 기도 확장 시술 후 치료 실패 위험 요인 분석

  • Park, Min Hae (Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, Nayeon (Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Song, Bok Hyun (Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jeong, Han-Sin (Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Son, Young-Ik (Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Chung, Man Ki (Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 박민혜 (성균관대학교 의과대학 삼성서울병원 이비인후과학교실) ;
  • 최나연 (성균관대학교 의과대학 삼성서울병원 이비인후과학교실) ;
  • 송복현 (성균관대학교 의과대학 삼성서울병원 이비인후과학교실) ;
  • 정한신 (성균관대학교 의과대학 삼성서울병원 이비인후과학교실) ;
  • 손영익 (성균관대학교 의과대학 삼성서울병원 이비인후과학교실) ;
  • 정만기 (성균관대학교 의과대학 삼성서울병원 이비인후과학교실)
  • Received : 2020.05.27
  • Accepted : 2020.06.09
  • Published : 2020.06.30
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Abstract

Background and Objective Endoscopic airway dilation is the primary treatment for pediatric subglottic stenosis (SGS) due to its feasibility and non-invasiveness. The aim of this study is to evaluate the risk factors for the failure of endoscopic airway dilation in pediatric patients with SGS. Materials and Methods This study reviewed medical records of 38 pediatric patients had endoscopic dilation from a single and tertiary referral center, retrospectively. The success of the endoscopic dilation procedure was defined as no dyspneic symptom without tracheostomy or laryngotracheal reconstruction. Demographic profiles, underlying disease, and Myer-Cotton SGS severity grade were recorded. Success rates and risk factors for the failure of treatment were analyzed. Results The SGS patients with severity grade I was most common. After mean 1.8 numbers of procedures, there were 23 patients (60.5%) in the success group and 15 patients (39.5%) in the failure group. Age, sex, underlying diseases, and SGS severity grade were not significantly different between two groups. In patients who had multiple endoscopic procedures, the failure group showed SGS deteriorated after procedures in 66.7%, compared to 11.1% of the success group. In multivariable analysis, a long-term intubation (≥1 month) was identified as an independent risk factor for failure of endoscopic dilation procedure. Conclusion Although endoscopic dilation procedure is safe and effective for the management, repetitive endoscopic dilation may not give clinical benefit in patient with long-term intubation. Other airway procedures must be considered in those group of patients.

Keywords

References

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