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Recurrent croup is a good indicator of underlying paediatric airway issues: A 10-year retrospective cohort study of airway endoscopy

Hampton, Thomas, Ghazal Asswad, Randa, Bhat, Jaya, Stevens, Kate, Whitehall, Emma, Milinis, Kristijonas, De, Su, Donne, Adam and Krishnan, Madhan (2023) 'Recurrent croup is a good indicator of underlying paediatric airway issues: A 10-year retrospective cohort study of airway endoscopy'. Ear, Nose & Throat Journal, 014556132311700. (In Press)

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Abstract

Objective
Children with a history of recurrent croup alert the ENT clinician to the potential for underlying laryngotracheal pathology. There is equipoise about the likelihood of identifying any underlying structural issues or subglottic stenosis in those children who undergo airway assessment.

Methods
A retrospective cohort study in a tertiary UK paediatric hospital of a decade of children with recurrent croup who underwent a rigid laryngo-tracheo-bronchoscopy (airway endoscopy).

Main Outcome(s)
airway pathology seen on endoscopy and need for further airway surgery.

Results
In ten years, 139 children underwent airway endoscopy for recurrent croup. Operative findings were abnormal in 62 (45 %) cases. Twelve cases (9%) had subglottic stenosis. Although recurrent croup was more common in males (78% of cases), this was not found to predispose them to operative findings. Children with previous intubations had >2 times the risk of abnormal findings and children born prematurely (<37 wks) had a trend towards abnormal operative findings versus children with no airway findings in our cohort. Even in those patients with abnormal findings, none necessitated further airway surgery.

Conclusions
Surgeons and parents can be reassured that rigid airway endoscopy for children with recurrent croup demonstrated high diagnostic utility but will rarely lead to further surgical intervention. Greater understanding about recurrent croup may require consensus clarification about definitions of recurrent croup and/or a universal adoption of a minimum standard operative record or grading system after rigid endoscopy for recurrent croup.

Item Type: Article
Subjects: WS Pediatrics > Child Care. Nutrition. Physical Examination > WS 130 In childhood
WS Pediatrics > WS 20 Research (General)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1177/01455613231170087
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 15 May 2023 13:28
Last Modified: 16 Feb 2024 13:37
URI: https://archive.lstmed.ac.uk/id/eprint/22493

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