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Cricotracheal resection in children weighing less than 10 kg

Erea-Noël Garabedian1, Richard Nicollas, Gilles Roger

  • 1Department of Pediatric Ear, Nose, and Throat, Armand-Trousseau Children's Hospital, Paris VI University, Assistance Publique-Hôpitaux de Paris, Paris, France. noel.garabedian@trs.ap-hop-paris.fr

Archives of Otolaryngology--Head & Neck Surgery
|June 22, 2005
PubMed

Insights

Cricotracheal resection (CTR) is safe and effective for infants under 10 kg with severe subglottic stenosis. This study shows comparable results to older children, avoiding long-term tracheotomy in most cases.

Area of Science:

  • Pediatric surgery
  • Otolaryngology
  • Respiratory medicine

Background:

  • Severe subglottic stenosis poses significant challenges in infants.
  • Cricotracheal resection (CTR) is a potential solution, but its application in very small children (<10 kg) is less documented.

Purpose of the Study:

  • To evaluate the safety and efficacy of cricotracheal resection (CTR) in pediatric patients weighing less than 10 kg.
  • To assess outcomes such as decannulation rates and the need for further interventions.

Main Methods:

  • Retrospective review of 17 pediatric patients (<10 kg) who underwent CTR between June 1995 and March 2003.
  • Analysis of patient demographics, stenosis severity, surgical approach (single-stage vs. multi-stage), hospitalization duration, and decannulation success.

Main Results:

  • The majority (88%) of patients had acquired subglottic stenosis, with most cases being grade 3 or 4.
  • A high decannulation rate (94%) was achieved, with most patients successfully decannulated within 15 days.
  • While some required further laser treatment for edema or granulomas, long-term tracheotomy was avoided in most patients.

Conclusions:

  • Cricotracheal resection (CTR) is a safe and effective surgical option for managing severe subglottic stenosis in infants weighing less than 10 kg.
  • The outcomes in this cohort are comparable to those reported for older children, establishing CTR as a viable procedure in this challenging weight category.
Abstract

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