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Anterior cricoid split. Update 1991.

F M Silver1, C M Myer, R T Cotton

  • 1Department of Otolaryngology, Children's Hospital Medical Center, Cincinnati, OH.

American Journal of Otolaryngology
|November 1, 1991
PubMed
Summary
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The anterior cricoid split (ACS) procedure for neonatal subglottic stenosis shows improved outcomes. Recent data reveals a 67% extubation rate and a reduced 4.1% mortality, highlighting advancements in managing this condition.

Area of Science:

  • Pediatric Otolaryngology
  • Neonatal Surgery
  • Respiratory Medicine

Background:

  • Neonatal subglottic stenosis management has evolved significantly since the anterior cricoid split (ACS) procedure's inception in 1980.
  • Established criteria for ACS patient evaluation have improved extubation and reduced mortality rates in reported series.

Purpose of the Study:

  • To review outcomes of 91 patients undergoing anterior cricoid split (ACS) for neonatal subglottic stenosis.
  • To analyze the results of 24 infants treated with ACS since 1988, focusing on extubation and mortality rates.

Main Methods:

  • Retrospective review of 91 patients who underwent anterior cricoid split (ACS) at Children's Hospital Medical Center.
  • Emphasis on a cohort of 24 infants treated between January 1, 1988, and the review period.

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Main Results:

  • The recent cohort of 24 infants achieved a 67% extubation rate.
  • Mortality in the recent cohort was significantly reduced to 4.1%, compared to a previous 10.4% rate.
  • Successful outcomes were achieved despite some flexibility in strict patient-selection guidelines.

Conclusions:

  • The anterior cricoid split (ACS) procedure remains an effective surgical intervention for neonatal subglottic stenosis.
  • Careful clinical evaluation and multidisciplinary consultation are crucial for optimal patient selection and outcomes in ACS.
  • Continued refinement of ACS management protocols contributes to improved patient survival and recovery.