A comparison of anterior cricoid split with and without costal cartilage graft for acquired subglottic stenosis

The use of the anterior cricoid split has allowed the extubation of multiple children who would otherwise require tracheostomy. Success, however, has been variable and difficult postoperative complications have occurred. Since 1981, 22 children at the Children's Hospital and Medical Center in Seattle, Washington have failed extubation because of subglottic disease as defined previously by Cotton and Seid. Two approaches have been used in managing the extubation of these children, one employing the anterior cricoid split and one employing the anterior cricoid split with immediate tracheoplasty using costal cartilage grafting. Immediate costal cartilage grafting resulted in fewer complications and a higher success rate in extubating patients with acquired subglottic stenosis.