Predicting graft width in endoscopic cricoid split using endotracheal tube outer diameter: a pediatric case series

Area of Science:

• Pediatric Otolaryngology
• Airway Surgery
• Surgical Reconstruction

Background:

• Pediatric airway stenosis often requires surgical intervention.
• Endoscopic Posterior Cricoid Split with Rib Graft (EPCS/RG) is a reconstructive technique.
• Accurate graft sizing is crucial for successful outcomes in EPCS/RG.

Purpose of the Study:

• To determine the correlation between endotracheal tube outer diameter (ETT OD) and graft width in EPCS/RG.
• To develop a predictive model for selecting appropriate graft size.
• To evaluate the impact of graft size on surgical outcomes.

Main Methods:

• Retrospective case series of 12 pediatric patients undergoing EPCS/RG.
• Analysis of correlation between ETT OD and graft width using linear regression and Pearson correlation.
• Assessment of secondary outcomes including tracheostomy status and operative time.

Main Results:

• A moderate-to-strong positive correlation (r=0.576, p=0.004) was found between ETT OD and graft width.
• A predictive equation was derived: Graft width = 0.6 + (0.9 × ETT OD).
• Tracheostomy avoidance or decannulation was achieved in 75% of patients.

Conclusions:

• Endotracheal tube outer diameter is a reliable predictor of graft width for EPCS/RG.
• The developed model offers a data-driven approach to graft sizing.
• Larger studies are needed to validate the predictive equation for pediatric airway reconstruction.