Cricotracheal resection in children

Abstract

Objective: To review our experience with cricotracheal resection in a pediatric population.

Design: Prospective case review of a cohort of patients undergoing cricotracheal resection.

Setting: Tertiary care pediatric hospital.

Patients: Forty-four consecutive patients undergoing cricotracheal resection between January 1, 1993, and December 31, 1998.

Main outcome measures: Decannulation rates.

Results: Thirty-eight (86%) of the 44 children are decannulated. The ultimate decannulation rate was independent of the presenting grade of subglottic stenosis. Fourteen children (100%) had a primary cricotracheal resection; all are decannulated. Twenty-one children had a salvage cricotracheal resection, and 19 (90%) are decannulated. Nine children had an extended cricotracheal resection, of whom 5 (56%) are decannulated. A primary cricotracheal resection was performed on a child on whom no previous open airway procedure had been performed. A salvage cricotracheal resection was performed on a child on whom previous open airway reconstruction had not resulted in an adequate airway. An extended cricotracheal resection was performed on a child on whom the cricotracheal resection was combined with a second procedure, either additional expansion cartilage grafting or an open arytenoid procedure. Most of these children had complex airway pathologic conditions.

Conclusion: Cricotracheal resection complements standard laryngotracheal reconstruction techniques in a pediatric population.