Related Experiment Videos
Margins of partial cricotracheal resection in children
D L Walner1, Y Stern, R T Cotton
1Department of Otolaryngology and Bronchoesophagology, Rush Presbyterian St. Lukes Medical Center, Chicago, Illinois 60612, USA.
Insights
Partial cricotracheal resection effectively treats severe subglottic stenosis in children, achieving over 86% success. Resection margins are tailored to individual patient anatomy for optimal outcomes.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Respiratory Medicine
Background:
- Severe subglottic stenosis poses significant airway challenges in children.
- Partial cricotracheal resection is a surgical option for managing this condition.
Purpose of the Study:
- To review surgical margins in partial cricotracheal resection for subglottic stenosis.
- To assess the utility of this procedure based on resection details and outcomes.
Main Methods:
- Retrospective review of 38 children with severe subglottic stenosis.
- Analysis of superior and inferior resection margins, stenosis grade, and stenting.
- Documentation of surgical details and postoperative outcomes.
Main Results:
- Superior margins varied, extending to the true vocal folds in some cases.
- Inferior margins typically reached the second tracheal ring.
- Surgical success, defined by decannulation, exceeded 86%.
Conclusions:
- Partial cricotracheal resection is a safe and successful treatment for pediatric subglottic stenosis.
- Resection margins and length require patient-specific tailoring.
- Careful airway management post-surgery is critical, especially with extensive resections.
Objective:
To review the surgical margins of partial cricotracheal resection in our series of patients. This includes specific anatomic detail as to each superior and inferior resection margin. To apply this information and access the utility of partial cricotracheal resection for the treatment of subglottic stenosis.
Study Design/Methods:
A retrospective review was performed of 38 children with severe subglottic stenosis who underwent partial cricotracheal resection. Information was obtained with regard to the specific anatomic location of the superior and inferior resection margins, the grade of subglottic stenosis preoperatively, the type of stenting material used postoperatively, and other surgical details specific to each procedure.
Results:
The superior resection margins were generally to the superior aspect of the cricoid cartilage but as high as the undersurface of the true vocal folds in a minority of patients. Inferior resection margins were generally to the second tracheal ring. Length of resection varied, but was as long as 3.0 cm in one patient. Overall surgical success based on decannulation was > 86%.
Conclusion:
Partial cricotracheal resection is a safe and successful procedure for the treatment of subglottic stenosis. The margins and length of resection should be tailored specifically for each patient; and special considerations must be taken when extensive resection to the level of the true vocal folds is required. Safe airway management in the postoperative period is essential.