Cryotherapy safe, effective in paediatric airway

Cryotherapy for the paediatric airway is safe and demonstrates a high success rate, results of a study have shown. In addition, cryobiopsy is not inferior to the commonly used forceps biopsies and may be used as an alternative in the future.

“Cryotherapy in interventional bronchoscopy is a new treatment modality, which has recently been made available for the paediatric airway,” the researchers said. “Lack of experience and safety concerns have led to hesitant adaptation.”

In this prospective study, the researchers invited bronchoscopists from medical centres who are performing cryotherapy in patients between 0 and 18 years to participate using an online questionnaire. They collected patient and participant data between June 2020 and June 2021.

Fifty-seven patients underwent a total of 69 cryotherapy procedures for the following indications: biopsy (n=30), restoration of airway patency (n=23), and foreign body aspiration (n=16).

Overall, cryotherapy had a 93-percent success rate; the other 7 percent were carried out to remove a foreign body and warranted a switch of technique. Bronchoscopists successfully applied airway patency restoration in various pathologies, including mucus plugs, bronchial casts, and post-traumatic stenosis.

In addition, the diagnostic yield of transbronchial biopsies was high at 96 percent.

Severe complications did not occur, but one pneumothorax following a cryobiopsy warranted a chest drain for 48 hours. No child was admitted to intensive care or died from a procedural complication.

“Paediatric bronchoscopists are encouraged to add cryotherapy to their armamentarium of airway interventions,” the researchers said.