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Management of subglottic stenosis in pregnancy using advanced apnoeic ventilatory techniques

Published online by Cambridge University Press:  12 April 2019

E J Damrose ,
L Manson ,
V Nekhendzy ,
J Collins  and
R Campbell
E J Damrose*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, California, USA
L Manson
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, California, USA
V Nekhendzy
Affiliation:
Department of Anesthesiology, Stanford University Medical Center, California, USA
J Collins
Affiliation:
Department of Anesthesiology, Stanford University Medical Center, California, USA
R Campbell
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, California, USA
*
Author for correspondence: Dr Edward J Damrose, Department of Otolaryngology, Head and Neck Surgery, 801 Welch Road, Stanford, CA 94305, USA E-mail: edamrose@stanford.edu Fax: +1 650 725 8502
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Abstract

Objective

To describe the use of balloon dilation with non-invasive ventilation in the treatment of pregnant patients with idiopathic subglottic stenosis.

Methods

The medical charts of four consecutive patients who underwent jet ventilation or high-flow nasal cannula oxygenation with balloon dilation for the treatment of idiopathic subglottic stenosis during pregnancy were reviewed.

Results

Objective improvement of subglottic stenosis was seen in all four cases, with end-result Myer–Cotton grade 1 lesions down from pre-procedure grade 3 lesions. Patients also reported subjective improvements in symptomatology, with no further airway issues. All patients delivered normally, at term.

Conclusion

Laryngeal dilation with continuous radial expansion pulmonary balloons using non-invasive ventilation for the treatment of idiopathic subglottic stenosis in pregnant patients is safe and efficacious, and should be the first line treatment option for this patient population. The improvement in symptoms, and lack of labour and pregnancy complications, distinguish this method of treatment from others reported in the literature.

Keywords

Acquired Subglottic StenosisHigh Frequency Jet VentilationPregnant WomenLaryngoscopyTransnasal Humdified Rapid-InsufflationVentilatory Exchange
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 133 , Issue 5 , May 2019 , pp. 399 - 403
Copyright
Copyright © JLO (1984) Limited, 2019 

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Footnotes

Dr E J Damrose takes responsibility for the integrity of the content of the paper

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