1. www.orl-marseille.com
Subglottic stenosis in children with
neurological disorders:
management and outcome
A Abbas, R Nicollas, I Sudre-Levillain, H Belaïche, S Roman,
JM Triglia
Dr Ali ABBAS
Pediatric ENT department
Timone Children Hospital
Marseille France
21/06/2006

2. Patients and methods
 n= 178 children (93 M / 85 F) operated on for subglottic
stenosis
 look for neurological disorders (polymalformative,
cranial trauma, tumor, metabolic coma, Ondine Sd…)
 Comparison of 2 populations

3. Patients and methods
Distribution of 2 populations
neuro+
n=39
22%
non-
neuro
n=139
78%

4. Results
Population criteria
etiology mean age grade
(months)
etiology : p=0,004 5% cong. 28% G2
age : p<0,001 neuro + 95% acquired 104 42% G3
30% G4
grade : p=0,015
26% cong. 34% G2
non-neuro 74% acquired 48 55% G3
11% G4

5. Results
Procedure criteria
single- two-stage
Procedure stage procedure
procedure : NS procedure
Single-S / two-S: 64% LTP
p=0,001 neuro + 13% CTR 25 % 75 %
23% laser
56% LTP
non-neuro 12% RCT 56 % 44 %
32% laser

6. Results
Procedure criteria
Calibrating
duration
Calibrating duration : p=0,025
neuro + 34,5 days
non-neuro 21,2 days

7. Results
Evolution criteria
Intensive Hospitalizatio
gastrostomy care unit n
NS neuro + 6,25 % (n=4) 4,7 d 37,5 d
non-neuro 5,75 % (n=8) 7,6 d 33,5 d

8. Discussion
 main problem : re-alimentation
Airway protection
Two stages procedure + anti-GER treatment