Incidence of severe acquired subglottic stenosis in newborns

Objective: To determine the change in the statewide incidence of severe acquired subglottic stenosis (SGS) in newborns over the past decade. Methods: Multicenter, statewide retrospective study of all patients under the age of 12 months who were diagnosed with acquired SGS that required surgical intervention by anterior cricoid split (ACS) or tracheostomy between 1993 and 2003. Results: There were 34 patients (19 male; 15 female) with a median age of 4 months at the time of surgery. The primary surgical intervention performed was ACS 20, and tracheostomy 14 (incidence rate of 41%). Subsequently, 11 patients who failed decannulation following ACS underwent tracheostomy. Five patients died due to reasons unrelated to their SGS, and among the 29 survivors, 8 remain cannulated. The overall success rate for ACS was 35%. The mean annual statewide incidence of severe acquired SGS over the 10-year period was 4.95 per 100,000 live births. Conclusion: The annual incidence of acquired SGS in newborns requiring open surgical intervention is in the order of 0.005%. The incidence of acquired SGS provides us with a benchmark figure that reflects the quality and standard of obstetric, neonatal and pediatric care across the state.