Cricotracheal resection for pediatric subglottic stenosis: update of the Lausanne experience

Controversy still exists concerning the best treatment modality for severe (Cotton's grade III and IV) subglottic stenosis in infants and children. Although laryngotracheoplasty procedures remain the operation of choice in most centres, this series of 26 partial cricoid resections with primary thyrotracheal anastomoses show a decannulation rate of 96% (25/26 cases) after a single open procedure. Twenty-three patients practice sport freely without dyspnea, 2 show a slight exertional stridor and one teenager experienced a complete restenosis. The postoperative voice is normal in 18 (70%) and a slight residual dysphonia is present in 7 (27%). We encountered no lesion to the recurrent laryngeal nerves and no fatalities. In 10 cases, the tracheostoma site was resected during the same operative session. In the future, cricotracheal resection should be considered as an important, if not the best, treatment option for severe subglottic stenosis in infants and children.