Serial intralesional triamcinolone acetonide injections for acquired subglottic stenosis in premature infants

Purpose Long-term intubation of premature infants sometimes induces acquired subglottic stenosis (SGS), causing glottic or supraglottic problems. These kinds of SGS often require tracheostomy and subsequently make decannulation difficult. The aim of our study was to clarify the efficacy of repeated intralesional steroid injections to the stenosis. Methods Six children with acquired SGS, who were treated with triamcinolone acetonide injections to the subglottic space just below the vocal folds between September 2015 and December 2017 were retrospectively reviewed. Results The patients’ mean age was 4.3 (range 1.3–4.4) years, the mean gestational age at birth was 25 (23–28) weeks, and the mean birth weight was 591 (456–734) g. The degree of SGS was grade II in one patient and III in five patients, with both tracheostoma and glottic or supraglottic abnormalities. They generally underwent ten procedures, every 3–4 weeks. In most cases, the patency of the injected space improved by 25–220%, and the symptoms were relieved. One patient achieved decannulation, and another one underwent laryngotracheal reconstruction and decannulation. Two patients started using a speech cannula. There were no severe complications. Conclusion Serial intralesional steroid injections are likely to be effective in improving the patency of acquired SGS.