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Safe balloon sizing for endoscopic dilatation of subglottic stenosis in children

Published online by Cambridge University Press:  18 January 2017

S D Sharma ,
S L Gupta ,
M Wyatt ,
D Albert  and
B Hartley
S D Sharma*
Affiliation:
Department of Paediatric Otorhinolaryngology, Great Ormond Street Hospital for Children, London, UK
S L Gupta
Affiliation:
Department of Paediatric Otorhinolaryngology, Great Ormond Street Hospital for Children, London, UK
M Wyatt
Affiliation:
Department of Paediatric Otorhinolaryngology, Great Ormond Street Hospital for Children, London, UK
D Albert
Affiliation:
Department of Paediatric Otorhinolaryngology, Great Ormond Street Hospital for Children, London, UK
B Hartley
Affiliation:
Department of Paediatric Otorhinolaryngology, Great Ormond Street Hospital for Children, London, UK
*
Address for correspondence: Mr Sunil Dutt Sharma, Department of Paediatric Otorhinolaryngology, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK Fax: +44 207 848 8644 E-mail: sunilsharma@doctors.org.uk
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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 StenosisCongenital Subglottic StenosisDilatationTracheal StenosisAirway Management
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 3 , March 2017 , pp. 268 - 272
Copyright
Copyright © JLO (1984) Limited 2017 

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