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Modified single-stage segmental cricotracheal resection.
Ihab Atallah1,2, Ahmed Aldkhyyal1,3, Paul F Castellanos4
1Division of Otolaryngology, Department of Surgery, University of Alabama at Birmingham, Boshell Building 563, Birmingham, AL, 35233, USA.
Summary
This study shows that extended cervical segmental tracheal resection (CTR) for severe airway narrowing is safe and effective. Modified CTR techniques allow for longer tracheal resections without increasing postoperative complications, improving patient outcomes.
Area of Science:
- Otolaryngology
- Thoracic Surgery
- Surgical Innovation
Background:
- Cricotracheal stenosis (CTS) often requires surgical intervention.
- Traditional tracheal resection techniques may limit the length of airway that can be safely removed.
- Severe CTS (Grade III-IV) necessitates advanced surgical approaches.
Purpose of the Study:
- To evaluate the safety and efficacy of modified cervical segmental tracheal resection (CTR) for long airway segments.
- To assess postoperative complication rates in patients undergoing extended CTR.
- To demonstrate the feasibility of resecting up to half the tracheal length for severe CTS.
Main Methods:
- Review of a consecutive series of 38 patients with Grade III-IV CTS.
- Application of modified CTR technique involving laryngosternopexy and continuous barbed sutures.
- Analysis of postoperative complications and outcomes, including decannulation rates.
Main Results:
- Successful decannulation in all 29 patients with prior tracheostomy.
- Low complication rate (5 patients), with only one requiring revision surgery for anastomosis-related issues.
- Modified CTR allowed resection of long tracheal segments with no increased risk of post-anastomosis airway leak.
Conclusions:
- Modified cervical segmental tracheal resection is a safe and effective option for managing long-segment cricotracheal stenosis.
- This technique enables the resection of extensive airway segments, comparable to traditional methods but with potential advantages.
- The modified CTR approach offers a viable solution for complex airway reconstruction without compromising patient safety.
