A Novel Endoscopic Anterior Cricoid Rib Grafting: A Feasibility Study in An Animal Model

Area of Science:

• Laryngology
• Surgical Innovation
• Animal Models

Background:

• Subglottic stenosis presents a significant challenge in airway reconstruction.
• Current single-stage reconstruction techniques have limitations.
• Novel surgical approaches are needed to improve patient outcomes.

Purpose of the Study:

• To evaluate the feasibility of a novel endoscopic anterior cricoid split and rib grafting technique.
• To assess the viability of this procedure in a goat airway model.
• To establish a foundation for future clinical applications in airway reconstruction.

Main Methods:

• A pilot feasibility study was conducted using three Ardhi goats.
• A rib graft was harvested and shaped, then secured with sutures.
• An endoscopic anterior cricoid split and balloon dilation were performed, followed by graft placement.
• Sutures were passed endoscopically and tied externally; a laryngeal stent was used in one case.

Main Results:

• The surgical procedure was successfully completed in all goats.
• Post-operative bronchoscopy at 7 days confirmed good graft positioning.
• One goat experienced a surgical site infection, resulting in partial graft resorption.

Conclusions:

• The novel endoscopic anterior cricoid split and rib grafting technique is feasible.
• This technique shows potential for single-stage airway reconstruction.
• Further research is warranted to assess safety and efficacy in subglottic stenosis models.