[Anteroposterior cricoid split interposition grafting for severe glottic and subglottic stenosis]

Abstract

Objective: To study the effect of anterior and posterior cricoid splitting interposition grafting for severe glottic and subglottic stenosis.

Methods: This is a retrospective study, from 1991 to 2001 years, 25 patients (male 15, female 10, aged 9 to 46 years) with severe glottic and subglottic stenosis were operated with anterior and posterior cricoid splitting interposition grafting method at Tangdu Hospital. All of 25 patients were tracheostomy dependent before reconstruction. 19 patients had previously undergone 1 to 7 (average 2) surgical procedures. The surgical technique consisted of laryngotracheostomy, cricoid lamina midline vertical incision; rib cartilage graft (17 cases), muscular fasciae, perichondrium or split-thickness skin graft (15 cases), pedicle arytenoid cartilage graft (2 cases) and thyroid cartilage graft (1 case) interposition and silicon T-tube stenting for 3 to 6 months.

Results: Twenty-four patients (96%) were successfully decannulated and got an effective phonation. One patient failed decannulation. The follow-up period ranged from 1 to 10 years. All of the 24 patients had a stable airway and effective phonation.

Conclusions: The anteroposterior cricoid split interposition graft technique was a safe and effective method for the treatment of severe glottic and subglottic stenosis. Careful split of the cricoid, avoiding injury of esophageal musculature, careful hemostasis, a tight suture graft and using stent were the keys of successful operation.