Chen Xiaoxuan, Pereira Nicola, Graw-Panzer Katharina, Ciecierega Thomas, Maresh Alison M
Department of Otolaryngology-Head and Neck Surgery, and MD Program, Weill Cornell Medical College, New York, NY, USA.
Department of Otolaryngology-Head and Neck Surgery, Pediatric Otolaryngology, Weill Cornell Medicine, New York, NY, USA.
Ann Otol Rhinol Laryngol. 2025 May;134(5):349-355. doi: 10.1177/00034894241312100. Epub 2025 Jan 6.
To evaluate the effectiveness of coordinated endoscopy with otolaryngology, pulmonology, and gastroenterology in diagnosing and managing recurrent croup in pediatric patients.
We reviewed our REDCap Pediatric Aerodigestive Database for patients with recurrent croup who underwent coordinated endoscopy between January 2013 and July 2023. We reviewed patient demographics, comorbidities, surgical findings, treatments, and outcomes.
Twenty-five patients were identified with recurrent croup. Their mean (SD) age was 37 (27) months (range = 9-98 months) with half of the patients younger than 25 months. The most common findings noted on combined endoscopies were positive bacterial culture on BAL (n = 10), and tracheomalacia (n = 7), and subglottic stenosis (n = 4). A history of prematurity was significantly associated with the presence of SGS ( = 0.01). Snoring/sleep-disordered breathing (SDB) was associated with a positive bacterial BAL culture ( = 0.03). About half of our cohort (48%) had multiple abnormalities identified by at least 2 different specialists at the time of endoscopy.
For patients experiencing frequent or severe recurrent croup episodes, a thorough aerodigestive evaluation and management plan should be pursued. Coordinated endoscopy may be considered for select patients who do not respond to medical treatment.
评估耳鼻喉科、肺病科和胃肠病科联合内镜检查在诊断和管理小儿复发性喉炎中的有效性。
我们回顾了2013年1月至2023年7月期间接受联合内镜检查的复发性喉炎患儿的REDCap儿科气道消化道数据库。我们回顾了患者的人口统计学资料、合并症、手术发现、治疗方法和结果。
确定了25例复发性喉炎患者。他们的平均（标准差）年龄为37（27）个月（范围=9-98个月），一半患者年龄小于25个月。联合内镜检查中最常见的发现是支气管肺泡灌洗（BAL）细菌培养阳性（n = 10）、气管软化（n = 7）和声门下狭窄（n = 4）。早产史与声门下狭窄的存在显著相关（P = 0.01）。打鼾/睡眠呼吸障碍（SDB）与BAL细菌培养阳性相关（P = 0.03）。我们队列中约一半（48%）的患者在内镜检查时被至少2名不同专科医生发现有多种异常。
对于频繁或严重发作复发性喉炎的患者，应进行全面的气道消化道评估和管理计划。对于药物治疗无反应的特定患者，可考虑联合内镜检查。
