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Published on: January 20, 2010
Cricotracheal resection in children
M J Rutter1, B E Hartley, R T Cotton
1Department of Otolaryngology, Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039, USA. ruttm0@chmcc.org
Insights
Cricotracheal resection is effective for pediatric airway stenosis, with 86% of patients decannulated. This surgical approach complements other airway reconstruction methods for children.
Area of Science:
- Pediatric surgery
- Otolaryngology
- Airway reconstruction
Background:
- Subglottic stenosis presents a significant challenge in pediatric airway management.
- Cricotracheal resection is a surgical option for severe cases.
- Evaluating the outcomes of cricotracheal resection in children is crucial.
Purpose of the Study:
- To review the experience and outcomes of cricotracheal resection in a pediatric cohort.
- To assess the decannulation rates following this procedure.
Main Methods:
- Prospective case review of 44 pediatric patients undergoing cricotracheal resection.
- Data collected between January 1993 and December 1998 at a tertiary care pediatric hospital.
- Main outcome measure was the rate of successful decannulation.
Main Results:
- 86% (38 of 44) of children were successfully decannulated.
- Primary cricotracheal resection had a 100% decannulation rate.
- Salvage and extended resections showed decannulation rates of 90% and 56%, respectively.
- Decannulation success was independent of the initial stenosis grade.
Conclusions:
- Cricotracheal resection is a valuable technique for managing pediatric subglottic stenosis.
- It serves as an effective complement to standard laryngotracheal reconstruction methods.
- The procedure offers a high success rate, particularly in primary cases.
Objective:
To review our experience with cricotracheal resection in a pediatric population.
Design:
Prospective case review of a cohort of patients undergoing cricotracheal resection.
Setting:
Tertiary care pediatric hospital.
Patients:
Forty-four consecutive patients undergoing cricotracheal resection between January 1, 1993, and December 31, 1998.
Main Outcome Measures:
Decannulation rates.
Results:
Thirty-eight (86%) of the 44 children are decannulated. The ultimate decannulation rate was independent of the presenting grade of subglottic stenosis. Fourteen children (100%) had a primary cricotracheal resection; all are decannulated. Twenty-one children had a salvage cricotracheal resection, and 19 (90%) are decannulated. Nine children had an extended cricotracheal resection, of whom 5 (56%) are decannulated. A primary cricotracheal resection was performed on a child on whom no previous open airway procedure had been performed. A salvage cricotracheal resection was performed on a child on whom previous open airway reconstruction had not resulted in an adequate airway. An extended cricotracheal resection was performed on a child on whom the cricotracheal resection was combined with a second procedure, either additional expansion cartilage grafting or an open arytenoid procedure. Most of these children had complex airway pathologic conditions.
Conclusion:
Cricotracheal resection complements standard laryngotracheal reconstruction techniques in a pediatric population.
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