Objectives: Severe subglottic stenosis (SGS) remains a challenge to manage. This case series study investigated the clinical course and treatment outcome of pediatric SGS at our institution .
Method: The medical charts of children were reviewed. Data included demographics, causes of disease, management, and treatment outcome.
Results: Nine patients were diagnosed with SGS and eight of them were treated between October 2010 and September 2017 at our institution. In all patients, SGS had been acquired and graded as 3 or 4, according to the Cotton-Myer classification. SGS had been caused by intubation in 7 cases, and the duration of intubation ranged from 7 to 86 days (median: 25.5 days). In the remaining two cases, the causes of SGS were surgery and penetrating trauma. Seven patients were treated with the “Trough method”, while one was treated with micro-laryngeal surgery. Decannulation was achieved in four cases, but a small tracheostomy fistula remained in other two cases in which the SGS was improved. In another patient, treatment was withheld due to compilation of the trachea defect following penetrating trauma, and in the other, treatment was rejected after re-stenosis occurred following management with the Trough method. The causes of re-stenosis and the need for multiple surgeries included granulation and scar formation around the superior tip of the T-tube that had been inserted into the trough.
Conclusion: The Trough method is a safe and technically simple procedure, and it could be a therapeutic option for SGS.
