The benefit and effectiveness of biodegradable drug-coated stents in treating refractory pediatric laryngotracheal stenosis.

Objectives: Laryngotracheal stenosis (LTS) is one of the most common causes of pediatric airway obstruction. Patients with LTS who receive multiple treatments but still fail to achieve decannulation are defined as having refractory LTS. Treatments for these patients are especially complicated and unsatisfactory. Biodegradable drug-coated stents (BDCSs) have the advantages of providing stable airway support, not requiring a second operation for removal, and preventing restenosis via the slow-release of a coated drug. We aimed to explore the role of BDCSs in treating refractory LTS.

Method: This study enrolled patients with refractory LTS who had undergone previous unsuccessful treatments between 2017 and 2023. Patients were divided into two groups on the basis of whether they received BDCS treatment (BDCS group, n = 30; non-BDCS group, n = 59). Success was defined as achieving decannulation.

Results: Among the 89 patients with refractory LTS, 66 patients (74.1%) eventually achieved decannulation. The decannulation rate was significantly greater in the BDCS group (P = 0.020). In patients who achieved decannulation, BDCSs significantly reduced the overall duration (P = 0.044) and total number of interventions (P = 0.029). We observed that 12 patients showed improvement in stenosis within one month after the postoperative follow-up, and those with a BDCS had a greater improvement rate (P = 0.047).

Conclusion: BDCSs could be a promising option for patients with severe refractory LTS.