Partial cricotracheal resection with primary anastomosis in the pediatric age group

Yoram Stern, David L. Walner, Mark E. Gerber, Robin T. Cotton*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

The traditional approach to severe subglottic stenosis (SGS) in the pediatric age group is laryngotracheal reconstruction (LTR). This approach may be complex and multistaged, with variable and unpredictable success rates in the individual patient. Excellent results have been reported in adults who had severe SGS and underwent partial resection of the cricoid and primary thyrotracheal anastomosis. This procedure has not been widely reported in infants and children. We report our experience with this procedure in 16 pediatric patients with grade III or IV SGS. Eleven patients had multiple previous LTR operations. The preoperative evaluation, surgical techniques, postoperative care, complications, and final results are described and discussed. Fourteen patients were decannulated after the procedure, 1 patient needed a second open procedure prior to decannulation, and 1 patient with concomitant bronchopulmonary dysplasia remains cannulated, for an overall 94% decannulation rate. Fourteen patients have no limitation of respiration, and 1 patient has moderate exercise intolerance. The results of this series suggest that partial cricotracheal resection with primary anastomosis is a relatively safe and effective procedure for pediatric patients with severe SGS.

Original languageEnglish
Pages (from-to)891-896
Number of pages6
JournalAnnals of Otology, Rhinology and Laryngology
Volume106
Issue number11
DOIs
StatePublished - 1997
Externally publishedYes

Keywords

  • Anastomosis
  • Child
  • Cricotracheal resection
  • Laryngotracheal reconstruction
  • Subglottic stenosis
  • Tracheal stenosis

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