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Related Experiment Videos

The cricoid split: an alternative to paediatric tracheostomy.

A Balakrishnan1

  • 1Department of Otolaryngology, Singapore General Hospital.

Annals of the Academy of Medicine, Singapore
|September 1, 1991
PubMed
Summary
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The Anterior Cricoid Split (ACS) offers an alternative to tracheostomy for preterm infants with subglottic stenosis, achieving a 77% extubation success rate. Careful patient selection and intensive care are crucial for this procedure.

Area of Science:

  • Neonatal Medicine
  • Pediatric Otolaryngology
  • Critical Care

Background:

  • Neonatal intensive care advances improve preterm infant survival but increase cases of acquired subglottic stenosis.
  • Respiratory Distress Syndrome and other cardiopulmonary issues necessitate ventilatory support, leading to extubation difficulties.
  • Traditionally, tracheostomy was performed after failed extubation attempts, with later definitive treatment.

Purpose of the Study:

  • To evaluate the Anterior Cricoid Split (ACS) as an alternative to tracheostomy in managing acquired subglottic stenosis in neonates.
  • To determine the efficacy and indications for ACS in improving extubation success rates.
  • To highlight the importance of patient selection and intensive care support for ACS.

Main Methods:

Related Experiment Videos

  • Review of outcomes following Anterior Cricoid Split (ACS) procedures since its first report in 1980.
  • Analysis of extubation success rates across multiple centers performing ACS.
  • Assessment of the expanded indications for ACS, including glottic pathology and existing tracheostomy.

    • Main Results:

    • The average extubation success rate following Anterior Cricoid Split (ACS) is approximately 77%.
    • ACS serves as a viable alternative to tracheostomy when performed with appropriate indications and strict patient selection.
    • The procedure is believed to decompress the laryngotracheal area, relieving pressure and edema of the cricoid ring.

    Conclusions:

    • Anterior Cricoid Split (ACS) is an effective alternative to tracheostomy for specific cases of acquired subglottic stenosis in neonates.
    • Successful ACS implementation requires meticulous patient selection and access to excellent intensive care facilities.
    • Tracheostomy remains a safer option when optimal intensive care is unavailable.