Rare Dual Subglottic Stenosis After Prolonged Intubation in a Pediatric Guillain-Barré Syndrome Patient: Successful Cryotherapy Treatment and Non-Surgical Approach

Abstract

Background: Guillain-Barré syndrome (GBS) is a rare, life-threatening neurological disorder often leading to respiratory failure that may require prolonged mechanical ventilation. A potential complication of prolonged intubation is subglottic stenosis (SGS), a narrowing of the airway below the vocal cords, which can cause significant respiratory difficulties.
Methods: In this study, a 4-year-old patient who underwent treatment with bougie dilation, balloon dilation, and cryotherapy for subglottic stenosis resulting from prolonged endotracheal intubation was examined. The post-treatment condition was assessed, and current non-surgical treatment options for subglottic stenosis were discussed.
Results: Bougie dilatation did not result in any improvement in the stridor. However, balloon dilatation and cryotherapy led to a significant reduction in stridor. Bronchoscopy performed one month after cryotherapy showed no signs of airway narrowing.
Conclusion: This case demonstrates the successful use of cryotherapy, including cryo-devitalization and cryo-extraction, in treating SGS in a pediatric patient. The absence of airway narrowing on follow-up suggests that cryotherapy is a promising non-surgical option for managing SGS in such cases.