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Use of Hyoid as Autologous Grafting Material

William F. McGuirt, Jr, MD; John P. Little, MD; Gerald B. Healy, MD

Arch Otolaryngol Head Neck Surg. 1997;123(12):1277-1280.

Abstract
Objective
To examine the use of hyoid as a readily available autologous grafting material for the anterior cricoid split (ACS) procedure.

Design
Prospective analysis of 20 patients undergoing ACS with hyoid interposition grafting for subglottic stenosis over a 3-year period. The patients received at least 1 year of follow-up after surgery.

Setting
Tertiary care children's hospital.

Patients
Twenty infants (age range, 2-9 months) with endoscopically confirmed acquired and congenital subglottic stenosis. Presenting symptoms included stridor, failure to extubate, and recurrent atypical croup. All 20 children underwent ACS with hyoid interposition grafting.

Results
All 20 patients exhibited improvement in their symptoms of airway obstruction. All 12 patients in whom extubation had previously failed subsequently underwent successful extubation. The 8 patients with symptoms of stridor and atypical croup showed marked improvement in their symptoms. Serial bronchoscopy revealed mucosal healing and incorporation of the hyoid grafts.

Conclusion
Hyoid provides a readily available and reliable grafting material for interposition grafting in the ACS procedure for neonates and infants.

Arch Otolaryngol Head Neck Surg. 1997;123:1277-1280

Author Affiliations
From the Department of Otolaryngology, Wake Forest University Medical Center, Brenner Children's Hospital, Winston-Salem, NC (Drs McGuirt and Little), the Department of Otolaryngology and Communication Disorders, The Children's Hospital (Dr Healy), and the Department of Otology and Laryngology, Harvard Medical School (Dr Healy), Boston, Mass.

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