(707) Epidemiological, Etiological and Surgical Outcomes of 321 Pediatric Subglottic Stenoses: A Retrospective Study.

Introduction:

Objective: To investigate epidemiological, etiological, and surgical outcomes of pediatric subglottic stenosis (PSS).
Study

Design: Retrospective case series.
Setting: Multicenter University Hospitals.

Methods: Medical records of 321 children treated for PSS at the National Scientific Center for Maternal and Child Health (Astana, Republic of Kazakhstan) from 2019 to 2024 were retrieved for demographic, etiological, and surgical outcomes. The following outcomes were collected: demographics, incidence by region (2018-2024), etiologies, grade of PSS according to the Myer-Cotton classification, type of interventions, and surgical outcomes.

Results: Of the 321 patients with subglottic stenosis, the mean age was 4.38 years. PSS was classified as Myer-Cotton grade I in 83 patients (25.9%), grade II in 163 patients (50.8%), grade III in 68 patients (21.2%), and grade IV in 7 patients (2.2%). A total of 389 surgical procedures were performed in the 321 PSS patients (1.2 procedures per patient), primarily consisting of balloon dilatation with transoral CO₂ laser tissue excision (n=191), transoral cold instrument tissue excision (n=89), and transoral CO₂ laser tissue excision without balloon dilatation (n=64). Additional procedures included bougienage (n=18), stent placement (n=3), T-tube placement (n=17), and partial laryngotracheal resection (n=1). Of the tracheotomized PSS patients, 73.1% were adequately decannulated postoperatively. The mean hospital stay was 9.0 ± 4.0 days.

Conclusions: Grade-tailored surgical approaches for PSS achieved favorable decannulation rates, with transoral procedures being effective for lower-grade stenoses in pediatric patients.