Balloon dilatation for paediatric airway stenosis: Evidence from the UK Airway Intervention Registry.
airway management
airway obstruction
dilatation
health information systems
patient safety
treatment outcome
Journal
Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
ISSN: 1749-4486
Titre abrégé: Clin Otolaryngol
Pays: England
ID NLM: 101247023
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
06
11
2019
accepted:
12
12
2019
pubmed:
18
12
2019
medline:
31
8
2021
entrez:
18
12
2019
Statut:
ppublish
Résumé
To assess the safety and efficacy in routine clinical practice of balloon dilatation procedures in the treatment of paediatric airway stenosis. Observational data collection in prospective online research database. Acute NHS Trusts with ENT department undertaking complex paediatric airway work. Children (<18) undergoing balloon dilatation treatment for airway stenosis. Airway diameter, complications, hospital resource usage. Fifty-nine patients had 133 balloon procedures during 128 visits to 10 hospitals. Sixty-nine (52%) of balloon procedures were conducted with a tracheostomy. Intra-operative Cotton-Myer grade decreased in 43 (57%). The mean pre-balloon subglottic diameter was 4.2 [95% CI: 3.8 to 4.5] mm, and its rate of increase was 0.8 [0.5 to 1.2] mm per year modelled on 30 patients' long-term data. As the primary treatment of stenosis, the procedural success rate of balloon dilatation (n = 52) was 65% (22% with tracheostomy, 88% without tracheostomy), and 71% as an adjunct to open reconstructive surgery (n = 7). In the 64 hospital visits where a balloon procedure was conducted with a tracheostomy in place, only one in-hospital complication (lower respiratory tract infection) occurred. For those without a tracheostomy in place, in-hospital complications occurred in seven of 64 balloon hospital visits, all related to ongoing or worsening stenosis. Six out-of-hospital complications were deemed related to ongoing or worsening stenosis following the procedure, and two complications were a combination of lower respiratory infection and ongoing or worsening stenosis. Balloon dilation increases the size of the airway intraoperatively and is associated with long-term increase in airway diameter. Safety outcomes mostly relate to ongoing or worsening stenosis and are more common in patients without a tracheostomy.
Identifiants
pubmed: 31845458
doi: 10.1111/coa.13492
pmc: PMC7317836
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
334-341Informations de copyright
© 2019 The Authors. Clinical Otolaryngology published by John Wiley & Sons Ltd.
Références
Clin Otolaryngol. 2020 May;45(3):334-341
pubmed: 31845458
Int J Pediatr Otorhinolaryngol. 2007 Jan;71(1):77-82
pubmed: 17046072
J Laryngol Otol. 2018 Nov;132(11):961-968
pubmed: 30394249
Pediatr Neonatol. 2019 Apr;60(2):141-148
pubmed: 29793843
Otolaryngol Head Neck Surg. 2014 Feb;150(2):174-9
pubmed: 24192289
Ann Otol Rhinol Laryngol. 2015 May;124(5):413-8
pubmed: 25519815
J Laryngol Otol. 1995 Sep;109(9):876-9
pubmed: 7494126
J Laryngol Otol. 2017 Mar;131(3):268-272
pubmed: 28095939
Int J Pediatr Otorhinolaryngol. 2013 May;77(5):623-8
pubmed: 23453794