Age, Experience Factors in Predicting Failure of Subglottic Stenosis Procedures

The median age of the children who had just one operation was 42 months, compared with an average age of 110 months for a child who required a second procedure (p < 0.001).

Dr. Nicollas said that eight of the 38 children who required a second operation were initially treated at the tertiary hospitals, whereas the other 30 children who needed the second procedure were referred from nonpediatric specialty facilities (p < 0.001).

There were 56 children in the group that required just one procedure who also were diagnosed with a neurological disorder-about 25% of the total group. But 16 of the 38 children requiring the second operation-42% of that group-were found to have neurological comorbidities (p = 0.0049).

Aside from those factors, the researchers did not find that other variables-including sex of the children-had an impact on whether the initial procedure failed.

We hope that one day this information will help us determine which children require special attention so that we do not have to perform a second procedure, said Dr. Nicollas. For us and the children who are our patients, failure is not an option.

Udayan Shah, MD, Pediatric Otolaryngologist at Nemours Children’s Clinic at the Alfred I. duPont Hospital for Children in Wilmington, DE, said the study offered by Dr. Nicollas provides interesting information for clinicians.

These data support the concept of interdisciplinary subspecialty care for children with airway stenosis. Such an approach benefits children and their families by involvement of pediatric gastroenterologists, pulmonologists and respiratory therapists, speech and swallowing specialists, and a safe home care regimen, said Dr. Shah. Further studies from other centers would be helpful to expand, as well as to confirm and to clarify, the data presented by Dr Nicollas and colleagues at ASPO.

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