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Michael J. Rutter, FRACS; Benjamin E. J. Hartley, FRCS; Robin T. Cotton, MD

Arch Otolaryngol Head Neck Surg. 2001;127:289-292.

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.

From the Division of Otolaryngology, Children's Hospital Medical Center, Cincinnati, Ohio. Dr Hartley is now with the Hospital for Sick Children, London, England.

Corresponding author and reprints: Michael J. Rutter, FRACS, Department of Otolaryngology, Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH 45229-3039 (e-mail: ruttm0{at}chmcc.org).

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