Subglottic enlargement using cartilage-mucosa autograft. A preliminary experimental study

Subglottic stenosis in the infant currently has no well-accepted surgical correction. Our experimental study was designed to determine the effectiveness of a nasal septal cartilage-mucosa autograft in increasing the subglottic circumference and its effect on subsequent subglottic growth. Six pairs of matched mongrel puppy litter mates were used; one underwent surgery, the other served as a control. The cricoid and first tracheal rings were split anteriorly, and widened 5 mm to accept an autogenous nasal septal cartilage-mucosa graft. All animals were killed after six months of postoperative growth. The autografts appeared to be partially or completely replaced by fibrous tissue but a persistent enlargement in the subglottic airway was found in the animals that underwent surgery, with glottic measurements the same in both groups. Thus, a septal cartilage autograft to the subglottic larynx in puppies appears to result in persistent enlargement of the subglottic area, but produces no interference with subsequent normal laryngeal growth and development.