ASPO044 - Practice Patterns and Complications of Balloon Dilation for Pediatric Airway Stenosis- A Survey of ASPO Members
Saturday, April 30, 2022
4:00 PM – 5:00 PM CT
Location: Landmark B
Carol Li, MD1, Robert Chun, MD2, Vikash K. Modi, MD3;
1Department of Otolaryngology – Head and Neck Surgery, Division of Pediatric Otolaryngology, Univ. of Cincinnati, Cincinnati Children’s Hosp. Med. Ctr., Cincinnati, OH, 2Pediatric Otolaryngology, Med. Coll. of Wisconsin, Milwaukee, WI, 3Division of Pediatric Otolaryngology, Weill Cornell Med., New York, NY.
Chief, Pediatric Otolaryngology, Associate Professor Well Cornell Medical College- New York Presbyterian Hospital New York, New York
Introduction: Endoscopic airway balloon dilation is heavily utilized in pediatric airway stenosis. The objective of this study was to gauge usage patterns and complications of balloon dilation among American Society of Pediatric Otolaryngology (ASPO) members.
Methods:An electronic survey was distributed to ASPO members. Data collected consisted of cumulative experience, technical details, and complications. Chi square and Fisher’s exact tests were used to examine the association between the number of respondents who experienced complications and techniques utilized.
Results: There were 138 respondents (response rate: 20%, 95% pediatric fellowship-trained). Experiences varied regarding balloon size, inflation pressure and duration. Seventy-six (55%) respondents reported balloon migration, 52 (37%) reported balloon rupture, 24 (17%) reported airway rupture, and 19 (13%) reported deflation malfunction. There was a higher percentage of respondents reporting deflation malfunction and airway ruptures in the group with a cumulative experience > 100 dilations (21% vs.5.8%, p = 0.012; 28% vs.7.3%, p = 0.003). More respondents reported deflation malfunction and airway rupture in the group who used pressures above nominal or burst pressure (80% vs. 10% p = 0.001; 60% vs.15%, p = 0.03). More respondents reported airway rupture in the group who used a non-Acclarent device (23% vs. 5.0%, p = 0.02). There were no significant associations between balloon size or duration of inflation and complications. Fifty percent reported an instance where stenosis worsened after dilation. Five percent of respondents reported prolonged hypoxia, 2.9% reported pulmonary edema, 3.6% reported pneumothorax, and 1.4% reported cardiac arrest. There were no balloon-associated deaths.
Conclusion: Practice patterns varied regarding the size, pressure, and inflation time. A significant proportion of practitioners have experienced balloon-related complications, such as airway rupture. Complications were more commonly reported in respondents who performed >100 cumulative dilations, used increased balloon pressures, and used non-Acclarent devices.