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Split-and-pool Synthesis and Characterization of Peptide Tertiary Amide Library

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Endoscopic cricoid split in a tertiary referral paediatric centre.

S Carr¹, A Dritsoula¹, R Thevasagayam¹

¹Department of Otolaryngology,Sheffield Children's Hospital,UK.

The Journal of Laryngology and Otology

|July 17, 2018

Summary

Endoscopic cricoid split is a safe and effective treatment for subglottic stenosis, achieving extubation rates comparable to open surgery. This minimally invasive technique offers shorter operative times and avoids external scarring.

Keywords:

Acquired Subglottic Stenosis Congenital Subglottic Stenosis Endoscopy Surgery

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Area of Science:

Otolaryngology
Pediatric Surgery
Respiratory Medicine

Background:

Subglottic stenosis (grades 2-3) can lead to extubation failure.
Anterior cricoid split is a treatment option, performed either endoscopically or via open surgery.
This study details a case series using a novel endoscopic technique.

Purpose of the Study:

To evaluate the efficacy and safety of endoscopic anterior cricoid split using a bespoke sickle knife.
To compare outcomes with traditional open procedures for subglottic stenosis.

Main Methods:

A case series of nine pediatric patients (including six pre-term infants) undergoing endoscopic cricoid split.
Procedures were performed between August 2012 and March 2015 in a tertiary referral center.

Main Results:

Six patients (67%) were on pre-operative oxygen; all five intubated patients were successfully extubated.
Mean age at operation was 30 weeks; mean intubation duration was 5.6 days.
Seven patients required repeat dilatations, and one needed a tracheostomy.

Conclusions:

Endoscopic cricoid split demonstrates comparable extubation rates to open procedures for subglottic stenosis.
It is a safe and efficient method for managing both acquired and congenital subglottic stenosis.
Key advantages include reduced operative time, no external scar, and no need for a drain.