Upper Airway Complications of Junctional Epidermolysis Bullosa

• Published in: The Journal of pediatrics 2012-04, Vol.160 (4), p.657-661.e1
• Main Authors: Ida, Jonathan B., MD, Livshitz, Irina, BSc, Azizkhan, Richard G., MD, Lucky, Anne W., MD, Elluru, Ravindhra G., MD, PhD
• Format: Article
• Language: English
• Subjects: Adolescent; Biological and medical sciences; bronchoscopy; Bullous diseases of the skin; Child; Child, Preschool; cold; Dermatology; epidermolysis bullosa; Epidermolysis Bullosa, Junctional - complications; Female; General aspects; Humans; Infant; Laryngeal Diseases - etiology; Laryngeal Diseases - therapy; Laryngoscopy; larynx; Male; Medical sciences; mucus; patients; Pediatrics; Retrospective Studies; Tracheal Diseases - etiology; Tracheal Diseases - therapy
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2011.09.029

Objective To assess the incidence of upper airway pathology in patients with junctional epidermolysis bullosa (JEB). Study design We conducted a retrospective chart review of all patients with JEB who came to an interdisciplinary epidermolysis bullosa center at a tertiary care institution between 2004 and 2010. Results Twenty-five patients with JEB were identified, and 12 patients were seen in the otolaryngology clinic (age range, 2 months-15 years; 8 male, 4 female). Of the 12 patients, 8 underwent rigid laryngoscopy and bronchoscopy for upper respiratory tract symptoms; 7 of these patients displayed laryngeal pathology, and 5 of them underwent surgical intervention with successful resolution of symptoms. Furthermore, none of these patients had any short- or long-term complications from their surgery. A strict protocol and a precise problem-focused cold surgical technique were used in these cases to protect skin and mucus membranes. Conclusion With appropriate precautions, endoscopic laryngeal surgery can be safe and effective in patients with JEB and larygnotracheal disease. Endoscopic laryngeal surgery is feasible when indicated for these patients.