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Clinical Experience With Extended Indications

Amelia F. Drake, MD; John W. Babyak, MD; John K. Niparko, MD; Charles F. Koopmann, MD

Arch Otolaryngol Head Neck Surg. 1988;114(12):1404-1406.

Abstract
• A recommended approach to post-extubation infant subglottic stenosis secondary to subglottic edema employs the recently described anterior cricoid split (ACS) procedure. This technique provides an expanded subglottic airway with minimal paratracheal dissection and does not require concomitant tracheotomy. We applied this procedure in managing extubation difficulty in pediatric as well as neonatal patients. Five of ten patients in our series did not fulfill the traditional criteria for ACS. Relief of stridor and avoidance of tracheotomy were accomplished in nine of ten patients. One patient in whom mechanical ventilation was reinstituted developed an interesting complication. In properly selected infants with subglottic airway compromise, the ACS appears to be an effective adjunct in facilitating extubation.

(Arch Otolaryngol Head Neck Surg 1988;114:1404-1406)

Author Affiliations
From the Departments of Otolaryngology, University of Michigan Medical Center (Drs Drake, Niparko, and Koopmann) and St Joseph's Mercy Hospital (Dr Babyak), Ann Arbor.

Footnotes
Accepted for publication Aug 12, 1988.

Reprint requests to Department of Otolaryngology, Box 0312, 1500 E Medical Center Dr, Ann Arbor, MI 48109 (Dr Niparko).

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