Neonatal subglottic stenosis - Incidence and trends

Objective/Hypothesis: Neonatal subglottic stenosis is a known entity arisin g from endotracheal tube intubation, In the 1970s and 1980s, estimates of t he incidence of subglottic stenosis were in the range of 0.9% to 8.3% of in tubated neonates, Because of improved techniques of handling neonates who r equire ventilatory support, we thought the actual incidence of neonatal sub glottic stenosis in the late 1990s was much lower. Study Design: We retrosp ectively reviewed all neonatal intensive-care unit (NICU) admissions from 1 997 at our institution, which serves as a level 3 NICU. We also performed a MEDLINE search of the reported incidence of neonatal subglottic stenosis b etween 1960 and 1999, Methods: Analysis was performed to identify all child ren who developed subglottic stenosis at our institution. Data were also co llected and analyzed with regard to average gestational age, average birth weight, average duration of intubation, and the number of children requirin g tracheostomy, The reports identified in the Literature were reviewed as t o the incidence of subglottic stenosis. Results: A total of 544 neonates we re admitted to the unit. Of these, 281 were intubated for an average of 11 days. No patients developed subglottic stenosis, Three patients required tr acheostomies for other reasons. All studies published after 1983 reported a n incidence of neonatal subglottic stenosis as less than 4.0%, and all stud ies published after 1990 reported an incidence of neonatal subglottic steno sis as less than 0.63%. Conclusions: Although our report applies to only a single institution in a single year, after reviewing the literature we thin k a downward trend exists in the incidence of neonatal subglottic stenosis in the late 1990s, The current incidence of neonatal subglottic stenosis is likely between 0.0% and 2.0%.