AI Article Synopsis

  • The study evaluates outcomes of two surgical methods—open and endoscopic techniques—for treating pediatric posterior glottic stenosis (PGS) using a meta-analysis of various studies.
  • A total of 19 studies involving 223 patients were included; most had high-grade PGS, with both methods showing high decannulation rates and significant improvement in airway obstruction.
  • Endoscopic methods presented a less invasive option, while both surgical approaches demonstrated effectiveness, making them viable treatments for severe cases of pediatric PGS.

Article Abstract

Objectives: To evaluate the outcomes of open and endoscopic posterior cricoid split grafting and mucosal flaps for the treatment of pediatric posterior glottic stenosis (PGS).

Data Sources: COCHRANE Library, CINAHL, PubMed, and Scopus databases.

Methods: Studies were grouped by treatment method. Outcomes included decannulation rate, improvement in airway obstruction, remaining vocal symptoms, and subsequent airway procedures. A meta-analysis of continuous measures and proportions (%) with 95% confidence interval (CI) was conducted.

Results: Nineteen studies with 223 patients were included, with 72 patients having isolated PGS. Twelve studies (n = 23) reported endoscopic repair (group 1), while seven studies (n = 49) reported open techniques (group 2). Most patients in group 1 and group 2 had grade IV PGS (55.9% [26.1%-83.5%] and 56.9% [30.5%-80.8%], respectively). Post-operatively, 70.8% [43.5%-91.7%] of group 1 patients had tracheostomies with 83.4% [62.1%-95.5%] subsequently being decannulated, whereas 97.3% [89.1%-99.8%] of group 2 patients had tracheostomies post-operatively with 90.2% [79.2%-96.5%] subsequently being decannulated. Group 1 and group 2 had 87.1% [70.5%-96.3%] and 84.4% [64.9%-95.5%] improvement in airway obstruction, respectively.

Conclusion: There are multiple open and endoscopic surgical options for pediatric PGS. Posterior cricoid split with cartilage graft and mucosal advancement flaps can be performed for high PGS grades. Endoscopic and open techniques are efficacious with high decannulation rates and improvement in airway obstruction, with endoscopic surgeries offering a less invasive approach. Laryngoscope, 2024.

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Source
http://dx.doi.org/10.1002/lary.31829DOI Listing

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