Cricotracheal resection as a primary procedure for laryngotracheal stenosis in children

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B E Hartley1, M J Rutter, R T Cotton

  • 1Department of Pediatric Otolaryngology, The Childrens Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229, USA. benhartley@msn.com

International Journal of Pediatric Otorhinolaryngology
|September 1, 2000
PubMed

Insights

Cricotracheal resection (CTR) as a primary procedure for severe laryngotracheal stenosis in children achieved an 88% decannulation rate. This study shows CTR is a viable alternative to laryngotracheal reconstruction (LTR) for pediatric airway stenosis.

Area of Science:

  • Pediatric surgery
  • Otolaryngology
  • Respiratory medicine

Background:

  • Severe laryngotracheal stenosis in children often requires surgical intervention.
  • Cricotracheal resection (CTR) is increasingly used, frequently as a salvage procedure after failed laryngotracheal reconstruction (LTR).
  • This study evaluates CTR as a primary treatment for severe pediatric laryngotracheal stenosis.

Purpose of the Study:

  • To examine the outcomes of children undergoing cricotracheal resection (CTR) as a primary procedure.
  • To assess the efficacy of CTR in treating severe laryngotracheal stenosis in pediatric patients without prior LTR.
  • To compare CTR with LTR as an initial treatment option.

Main Methods:

  • Analysis of a prospectively collected database.
  • Inclusion of 17 pediatric patients with grade 3 or 4 laryngotracheal stenosis who underwent primary CTR.
  • Minimum 1-year follow-up period to assess decannulation and voice outcomes.

Main Results:

  • An 88% decannulation rate was achieved within 1 year post-primary CTR.
  • Fifteen out of 17 patients were decannulated; 5 required additional surgical procedures.
  • Two patients with complex conditions (vocal cord paralysis, congenital anomalies) remained with tracheostomies.
  • Voice outcomes were variable, with 9 patients having good voice, 5 acceptable, and 3 weak or no voice.

Conclusions:

  • Primary cricotracheal resection (CTR) is an effective treatment for severe pediatric laryngotracheal stenosis, achieving a high decannulation rate.
  • CTR offers a viable alternative to laryngotracheal reconstruction (LTR) as a primary surgical approach.
  • Further investigation into the specific indications for primary CTR versus LTR is warranted.
Abstract

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