Serial intralesional steroid injection combined with balloon dilation as an alternative to open repair of subglottic stenosis

This article will describe successful use of serial balloon dilations and steroid injections to help a child with acute SGS avoid tracheotomy or major reconstructive procedures. An 11-month infant presented with subglottic ulcerations that developed after intubation for acute laryngotracheitis. Over the next 4 months, the child developed SGS, requiring three balloon dilations consisting of triamcinalone injection into the scar tissue followed by outpatient balloon dilation without intraoperative intubation. Twelve months after initial presentation and 8 months follow-up from the third and final dilation, the patient is thriving. This report illustrates the potential safety and efficacy of serial intralesional steroids combined with balloon dilation as an alternative to more invasive treatments. The technique is novel in the number of attempts at balloon dilation, highlighting that serial dilations can succeed after initial failure. Issues for further investigation include optimal timing and number of dilations.