Partial cricotracheal resection with primary anastomosis for pediatric laryngotracheal stenosis

Severe laryngotracheal stenosis (LTS) in the pediatric age group has been traditionally treated by laryngotracheoplasty procedures. This approach may be complex and multistaged. High success rates have been reported in adults with severe LTS who underwent partial resection of the cricoid and primary thyrotracheal anastomosis. However, this procedure has not been widely reported in infants and children. Since November 1993, 38 patients with grade III or IV subglottic stenosis were treated with partial cricotracheal resection (CTR) and primary anastomosis. In some patients a posterior cricoid split or partial arytenoidectomy was performed as well. The preoperative evaluation, surgical techniques, and postoperative care are described. There were no significant operative complications or deaths. Thirty-three patients were decannulated after a single open surgical procedure. Our results as well as those of previous series suggest that CTR with primary anastomosis is a relatively safe and effective procedure in infants and children with severe LTS.