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Anterior cricoid split. Use of hyoid as autologous grafting material
W F McGuirt1, J P Little, G B Healy
1Department of Otolaryngology, Wake Forest University Medical Center, Brenner Children's Hospital, Winston-Salem, NC, USA.
Objective:
To examine the use of hyoid as a readily available autologous grafting material for the anterior cricoid split (ACS) procedure.
Design:
Prospective analysis of 20 patients undergoing ACS with hyoid interposition grafting for subglottic stenosis over a 3-year period. The patients received at least 1 year of follow-up after surgery.
Setting:
Tertiary care children's hospital.
Patients:
Twenty infants (age range, 2-9 months) with endoscopically confirmed acquired and congenital subglottic stenosis. Presenting symptoms included stridor, failure to extubate, and recurrent atypical croup. All 20 children underwent ACS with hyoid interposition grafting.
Results:
All 20 patients exhibited improvement in their symptoms of airway obstruction. All 12 patients in whom extubation had previously failed subsequently underwent successful extubation. The 8 patients with symptoms of stridor and atypical croup showed marked improvement in their symptoms. Serial bronchoscopy revealed mucosal healing and incorporation of the hyoid grafts.
Conclusion:
Hyoid provides a readily available and reliable grafting material for interposition grafting in the ACS procedure for neonates and infants.