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Subtotal submucosal cricoid resection: an experimental study.

A Shaha1, C Burnett, T Dimaio

  • 1Department of Surgery, SUNY-Health Science Center, Brooklyn 11203.

Journal of Surgical Oncology
|November 1, 1991
PubMed
Summary
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Subtotal cricoid cartilage resection in dogs was well-tolerated, demonstrating that this cartilage is not essential for airway continuity. Polytetrafluoroethylene (PTFE) grafts effectively reconstructed defects, preventing airway narrowing and subglottic stenosis.

Area of Science:

  • Laryngology
  • Surgical Innovation
  • Comparative Anatomy

Background:

  • The cricoid cartilage is traditionally considered vital for maintaining airway patency.
  • Previous assumptions questioned the necessity of complete cricoid cartilage integrity for airway continuity.

Purpose of the Study:

  • To experimentally evaluate the effects of subtotal cricoid cartilage excision in canines.
  • To assess the feasibility of reconstructing cricoid cartilage defects with a synthetic graft.

Main Methods:

  • Subtotal cricoid resection via submucosal dissection in eight adult mongrel dogs.
  • Reconstruction of the cartilage defect using a polytetrafluoroethylene (PTFE) graft.
  • Post-operative monitoring for respiratory distress, need for ventilation, and swallowing function.

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Main Results:

  • All dogs tolerated extubation immediately and showed no respiratory compromise or need for tracheostomy.
  • Animals resumed eating shortly after surgery and exhibited no signs of airway narrowing or subglottic stenosis during 4-6 months follow-up.
  • Histological examination revealed fibrous scarring externally but intact mucosa and normal airway dimensions.

Conclusions:

  • Subtotal cricoid cartilage resection is well-tolerated in canines, challenging its essential role in airway continuity.
  • Polytetrafluoroethylene (PTFE) grafts provide a viable method for reconstructing cricoid cartilage defects.
  • This approach prevents subglottic stenosis and maintains airway patency effectively.