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Partial cricotracheal resection in children weighing less than 10 kilograms
Christos Ikonomidis1, Mercy George, Yves Jaquet
1Department of Otolaryngology, Head and Neck Surgery, University Hospital, Lausanne, Switzerland. Christos.Ikonomidis@chuv.ch
Insights
Partial cricotracheal resection (PCTR) is safe and effective for infants and children under 10 kg with subglottic stenosis, showing comparable long-term outcomes to heavier children. This surgical technique offers good results for breathing and swallowing.
Area of Science:
- Pediatric surgery
- Otolaryngology
- Respiratory medicine
Background:
- Subglottic stenosis presents a significant challenge in pediatric airway management.
- Partial cricotracheal resection (PCTR) is a surgical option for treating subglottic stenosis.
- Assessing outcomes in low-weight infants (<10 kg) is crucial for surgical decision-making.
Purpose of the Study:
- To evaluate the long-term safety and efficacy of PCTR in infants and children weighing less than 10 kg.
- To compare the outcomes of PCTR in low-weight children with those of heavier children.
- To analyze factors influencing decannulation and long-term functional results.
Main Methods:
- A historical cohort study compared 36 children (<10 kg) with 65 children (>10 kg) undergoing PCTR.
- Kaplan-Meier and Cox regression analyses were used to assess decannulation rates and time.
- Long-term outcomes (breathing, voice, swallowing) were evaluated via questionnaires.
Main Results:
- The decannulation rate was 92% in the low-weight group (<10 kg).
- No significant differences in outcomes were observed between the low-weight and heavier groups.
- Long-term follow-up (median 9 years) showed normal breathing (72%) and swallowing (90%), with 71% reporting rough or weak voice.
Conclusions:
- PCTR is a safe and effective surgical technique for subglottic stenosis in infants and children weighing less than 10 kg.
- Long-term results in low-weight children are comparable to those in older, heavier children.
- PCTR offers favorable functional outcomes for breathing and swallowing in this pediatric population.
Objectives:
To assess the long-term outcome, safety, and efficacy of partial cricotracheal resection (PCTR) for subglottic stenosis in a group of children and infants weighing less than 10 kg at the time of the surgery.
Study Design:
Historical cohort study.
Setting:
Academic tertiary medical center.
Subjects And Methods:
Thirty-six children weighing less than 10 kg at the time of the surgery were compared to a group of 65 children who weighed more than 10 kg. The Kaplan Meier method and Cox regression were carried out to detect differences in decannulation time and rates and to examine the influence of various parameters (i.e., comorbidities, type of surgery, and complications requiring revision surgery) at the time of decannulation. Evaluation of the long-term outcome was based on questionnaires assessing breathing, voice, and swallowing.
Results:
Decannulation rate was 92 percent (33/36) for the group of children weighing less than 10 kg. No significant differences were found between the two body weight groups with respect to the aforementioned covariates. The median follow-up period was nine years (range, 1-23 yrs). Questionnaire responses revealed completely normal breathing and swallowing in 72 percent and 90 percent of the children, respectively. Seventy-one percent of the patients considered their voice to be rough or weak.
Conclusion:
PCTR in infants and children weighing less than 10 kg is a safe and efficient technique with similar long-term results when compared to results seen in older and heavier children.
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