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Cricotracheal resection in children 2 years of age and younger
Romaine F Johnson1, Michael Rutter, Robin Cotton
1Department of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Medical Center, Cincinnati, Ohio, USA.
Insights
Cricotracheal resection is a safe and effective surgical option for infants and young children. This study found similar outcomes for decannulation and complications in children under two years old compared to older patients.
Area of Science:
- Pediatric Surgery
- Otolaryngology
- Airway Reconstruction
Background:
- Congenital or acquired conditions can cause severe upper airway obstruction in children.
- Cricotracheal resection (CTR) is a surgical procedure to address such obstructions.
- Outcomes of CTR in very young children (≤2 years) require specific evaluation.
Purpose of the Study:
- To evaluate the surgical outcomes of cricotracheal resection in children aged 2 years or younger.
- To compare outcomes between pediatric patients ≤2 years and those >2 years undergoing CTR.
Main Methods:
- Retrospective case study at a tertiary care children's hospital (1993-2006).
- Compared patients ≤2 years (n=15) with patients >2 years (range 2-44 years).
- Primary outcomes: decannulation and complication rates; statistical analyses included chi-squared, t-tests, and logistic regression.
Main Results:
- Overall decannulation rate was 87% with 2 failures in the ≤2 years group.
- Patients ≤2 years were more likely to undergo single-stage procedures (p < .01) and CTR as their first airway reconstruction (p = .002).
- Complication and decannulation rates were similar between the two age groups.
Conclusions:
- Cricotracheal resection is a safe and effective surgical intervention for children 2 years of age and younger.
- The procedure yields comparable outcomes to older pediatric patients.
- CTR offers a viable solution for airway reconstruction in the youngest pediatric population.
Objectives:
We examine the surgical outcomes of cricotracheal resection in children 2 years of age and younger.
Methods:
We performed a retrospective case study involving a single tertiary care children's hospital. All patients who underwent cricotracheal resection from 1993 through January 2006 were included. Patients 2 years old and younger were compared to patients more than 2 years of age (range, 2 to 44 years). The primary outcomes measured were decannulation and complication rates. We used chi2 analyses for categorical variables to detect differences in proportions, Student's t-tests for continuous data, and logistical regression to explore for confounding. Significance was set at alpha = .05, 2-tailed.
Results:
Fifteen children 2 years of age or younger were identified. Most patients underwent a single-stage operation (n = 12). The overall decannulation rate was 87% (2 failures). Two patients younger than 2 years had postoperative complications, including 1 patient who developed anastomosis dehiscence. When compared to the patients over 2 years of age, patients younger than 2 were more likely to undergo a single-stage procedure (p < .01). Additionally, the cricotracheal resection was more likely to be their first attempt at airway reconstruction (p = .002). Complication and decannulation rates were similar in both groups.
Conclusions:
Cricotracheal resection can be performed safely and effectively in children less than 2 years old.
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