Partial Cricotracheal Resection (PCTR), a Rewarding Outcome for Paediatric Subglottic Stenosis: An Early Experience

Area of Science:

• Pediatric Otolaryngology
• Laryngology
• Pediatric Surgery

Background:

• Subglottic stenosis is a serious airway complication in children.
• Acquired subglottic stenosis, often due to prolonged intubation, requires surgical intervention.
• Severe cases (Myer-Cotton grades III and IV) present significant management challenges.

Purpose of the Study:

• To evaluate the efficacy and safety of partial cricotracheal resection (PCTR) as a primary surgical treatment for pediatric subglottic stenosis.
• To assess outcomes in patients with severe subglottic stenosis (Myer-Cotton grades III and IV).

Main Methods:

• Retrospective study of 5 pediatric patients (ages 3-18) with acquired subglottic stenosis treated between 2004-2012.
• All patients underwent a two-staged partial cricotracheal resection (PCTR).
• One patient also received a posterior cordectomy.

Main Results:

• All 5 patients had acquired subglottic stenosis secondary to prolonged intubation.
• Three patients were Myer-Cotton grade III, and two were grade IV.
• All patients were successfully decannulated postoperatively.
• Two patients had concurrent bilateral vocal cord immobility.

Conclusions:

• Partial cricotracheal resection (PCTR) is an effective and safe surgical option for pediatric subglottic stenosis.
• PCTR demonstrates positive outcomes, including successful decannulation, for severe cases (Myer-Cotton grades III and IV).
• This early institutional experience supports PCTR for complex pediatric airway reconstruction.