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Arytenoid prolapse as a consequence of cricotracheal resection in children

M J Rutter1, D T Link, B E Hartley

  • 1Department of Pediatric Otolaryngology, Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.

The Annals of Otology, Rhinology, and Laryngology
|March 28, 2001
PubMed

Insights

A new complication of cricotracheal resection (CTR) in children is arytenoid cartilage prolapse. This condition can cause breathing difficulties or be asymptomatic, and is effectively treated with endoscopic laser partial arytenoidectomy.

Area of Science:

  • Pediatric Otolaryngology
  • Surgical Complications
  • Airway Management

Background:

  • Cricotracheal resection (CTR) is a surgical technique for severe pediatric laryngotracheal stenosis.
  • Known complications include nerve damage, dehiscence, and restenosis.
  • This study identifies arytenoid cartilage prolapse as a novel CTR complication.

Purpose of the Study:

  • To describe arytenoid cartilage prolapse as a complication of pediatric cricotracheal resection.
  • To outline diagnostic methods and treatment options for this condition.
  • To report the incidence and outcomes of arytenoid prolapse in children post-CTR.

Main Methods:

  • Retrospective review of 44 children undergoing CTR.
  • Diagnosis via flexible nasopharyngoscopy or rigid endoscopy.
  • Assessment of symptoms, including dyspnea and nocturnal stertor.
  • Evaluation of treatment outcomes, including laser arytenoidectomy and CPAP.

Main Results:

  • Twenty of 44 children (45%) developed post-operative arytenoid prolapse.
  • Twelve patients (27%) were asymptomatic.
  • Eight patients (18%) required endoscopic laser partial arytenoidectomy.
  • Two patients (4.5%) developed moderate supraglottic collapse requiring CPAP.

Conclusions:

  • Arytenoid cartilage prolapse is an underrecognized complication of pediatric CTR.
  • Diagnosis can be made with laryngoscopy, and treatment with laser arytenoidectomy is effective.
  • While often asymptomatic, prolapse can lead to significant airway obstruction requiring intervention.

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