Posterior Cricoidotomy Lumen Augmentation for Treatment of Subglottic Stenosis in Children

Abstract

The posterior cricoidotomy lumen augmentation is a safe and effective technique for the treatment of moderate and severe subglottic stenosis in children of any age. This study lends further support to the assertion that external surgery does not affect the growth of the larynx in younger children.

Posterior cricoid split with costal cartilage augmentation for high subglottic stenosis

“…Nevertheless, the procedure has now become fi rmly established. The literature includes several reports wherein posterior cricoid split and augmentation ( with or without additional anterior cricoid augmentation) has been applied to the treatment of subglottic, glottic and combined glottic-subglottic stenosis with successful decannulation rates of greater than 90% have been reported [2,[6][7][8][9][10][11]. We have found posterior cricoid split with rib augmentation to be remarkably effi cacious in expanding the subglottic airway, and also to be free from complications over a follow up period ranging to two years.…”

“…Techniques used range from laser vaporization of the scarred tissues combined with luminal stenting [1], to laryngotracheal reconstruction (LTR) with an anterior or posterior cricoid split and augmentation of the cricoid arch with an anterior costal cartilage graft [7][8][9][10][11]. The results employing laser surgery have been proved disappointing in cases of extensive subglottic stenosis [9].…”

Endoscopie posterior cricoid split and rib grafting in 10 children

“…The value of the posterior cricoid costal cartilage graft is well established for airway expansion in cases of PGS and BVCP 3,4,6 and as an adjuvant to anterior cricoid grafting in SGS. Performing posterior cricoid costal cartilage graft in the traditional open fashion has significant drawbacks, however.…”

Fibroblast Transplantation in the Airway

“…UBGLOTTIC STENOSIS (SGS) IN children, especially newborns, has become increasingly more prevalent during the past quarter century owing to widespread adoption of prolonged endotracheal intubation for respiratory support. [1][2][3][4][5][6][7][8][9][10][11][12] Current therapeutic approaches to SGS are largely surgical in nature, addressing the gross pathology associated with airway narrowing. [9][10][11][12] Unfortunately, surgical approaches are associated with postoperative alterations in airway morphology and function.…”

“…9 Although other techniques may improve on this outcome, normal vocalization is recovered in only 25% to 33% of patients undergoing reconstruction and decannulation. [10][11][12] We hypothesized that a minimally invasive approach to correction of SGS may meet with improved success, especially for secondary outcome measures such as proper vocalization. An understanding of the cellular and molecular processes underlying the formation of SGS is of para-mount importance for the development of such novel therapeutic strategies.…”