{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T11:37:40Z","timestamp":1791632260572,"version":"4.3.4"},"reference-count":9,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,11,5]],"date-time":"2013-11-05T00:00:00Z","timestamp":1383609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Endoscopic balloon dilation (EBD) is an inviting, noninvasive option to manage pediatric subglottic stenosis that could preclude the need for tracheostomy and\/or laryngeal\u2010tracheal reconstruction (LTR). However, treatment outcomes and patient selection criteria are not well described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>MEDLINE, EMBASE, and the Cochrane databases were systematically searched using multiple search terms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>A systematic review of pediatric EBD was performed and then reported in compliance with PRISMA principles. Inclusion criteria consisted of a sample size of 5 or greater, pediatric patients, and primary EBD without adjuvant procedures. Meta\u2010analysis was performed with random effects modeling and pooled data regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After systematic database search and detailed review, 7 studies were included in the final data set with 150 total subjects. All studies were case series (level 4 evidence). The mean sample size was 20 subjects (range, 5\u201044), and the grand mean age was 2.2 years (range, 2.2\u201060\u00a0months). The random effects model estimate of the overall treatment success (avoidance of tracheostomy or LTR) was 65.3% (k = 6 studies, 95% confidence interval [CI] = 60.1%\u201070.6%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;. 001, Q test for heterogeneity = 3.98,\n                      <jats:italic>P<\/jats:italic>\n                      =. 552, I\n                      <jats:sup>2<\/jats:sup>\n                      = 0%). Follow\u2010up was inconsistently reported but averaged 4.6\u00a0months (range, 0.25\u201012.5\u00a0months). Only 1 study reported significant complications (1 death, 2 tracheal lacerations). Pooled data multivariate regression indicated that increasing Cotton\u2010Meyers grade was associated with decreased odds of success (odds ratio = 0.198, 95% CI = 0.0451\u20100.870,\n                      <jats:italic>P<\/jats:italic>\n                      =. 032). Funnel plot analysis suggested the possibility of publication bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EBD is successful in most patients over short\u2010term follow\u2010up. The reported complication rates are low. Increasing severity of subglottic stenosis increases the odds of treatment failure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0194599813510867","type":"journal-article","created":{"date-parts":[[2013,11,5]],"date-time":"2013-11-05T22:35:30Z","timestamp":1383690930000},"page":"174-179","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":89,"title":["A Systematic Review and Meta\u2010analysis of Endoscopic Balloon Dilation of Pediatric Subglottic Stenosis"],"prefix":"10.1002","volume":"150","author":[{"given":"Michael","family":"Lang","sequence":"first","affiliation":[{"name":"Uniformed Services University Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott E.","family":"Brietzke","sequence":"additional","affiliation":[{"name":"Uniformed Services University Bethesda Maryland USA"},{"name":"Walter Reed National Military Medical Center Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,11,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1177\/000348949410300410","article-title":"Proposed grading system for subglottic stenosis based on endotracheal tube sizes","volume":"103","author":"Myer CM","year":"1994","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/0022-3468(91)90843-I","article-title":"Balloon tracheoplasty in children: results of a 15\u2010year experience","volume":"26","author":"Hebra A","year":"1991","journal-title":"J Pediatr Surg"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1001\/archotol.133.8.772","article-title":"Balloon laryngoplasty as a primary treatment for subglottic stenosis","volume":"133","author":"Durden F","year":"2007","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1177\/000348941011900909","article-title":"Balloon dilation for recurrent stenosis after pediatric laryngotracheoplasty","volume":"119","author":"Bent JP","year":"2010","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"e_1_2_9_6_1","first-page":"711","article-title":"Balloon laryngoplasty in children with acute subglottic stenosis: experience of a tertiary\u2010care hospital","volume":"77","author":"Schweiger C","year":"2011","journal-title":"Braz J Otorhinolaryngol"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1177\/000348941212100704","article-title":"Outcomes of balloon dilation in pediatric subglottic stenosis","volume":"121","author":"Whigham AS","year":"2012","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"e_1_2_9_8_1","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1001\/archoto.2011.1439","article-title":"Balloon dilation laryngoplasty for subglottic stenosis in children: eight years\u2019 experience","volume":"138","author":"Hautefort C","year":"2012","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1001\/jamaoto.2013.676","article-title":"The effects of balloon dilation laryngoplasty in children with congenital heart disease","volume":"138","author":"Collins WO","year":"2012","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1111\/j.0006-341X.2000.00455.x","article-title":"Trim and fill: a simple funnel\u2010plot\u2010based method of testing and adjusting for publication bias in meta\u2010analysis","volume":"56","author":"Duval S","year":"2000","journal-title":"Biometrics"}],"container-title":["Otolaryngology\u2013Head and Neck 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