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Published on: June 20, 2018
Posterior cricoid split with costal cartilage augmentation for high subglottic stenosis
T Pradhan1, Sikka Kapil, A Thakar
1All India Institute of Medical Sciences, New Delhi, 110 029 India.
Summary
High subglottic stenosis can be effectively treated using a posterior cricoid split and costal cartilage graft. This surgical approach successfully restored airways and enabled decannulation in all patients.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Airway Reconstruction
Background:
- Upper subglottic stenosis poses unique challenges due to proximity to vocal folds, often causing fixation.
- Traditional surgical methods like cricotracheal resection are unsuitable for this condition.
Purpose of the Study:
- To evaluate the efficacy of posterior cricoid split with free costal cartilage graft for high subglottic and posterior commissure glottic stenosis.
- To report outcomes in patients with severe, treatment-resistant stenosis.
Main Methods:
- A retrospective review of four patients with Grade III/IV stenosis treated with posterior cricoid split and costal cartilage graft via laryngo-fissure.
- Post-operative airway stenting with a T-Tube for 4 months.
Main Results:
- All four patients achieved successful airway restoration.
- Decannulation was successful in all cases following treatment.
Conclusions:
- Posterior cricoid split combined with costal cartilage grafting is a highly effective treatment for severe upper subglottic stenosis.
- This technique offers a successful solution for complex airway stenosis recalcitrant to other therapies.
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