This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on ISI (1)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Laryngology/ Speech/ Language Pathology  • Pediatric Otolaryngology  • Otolaryngology/ Head & Neck Surgery, Other  • Prognosis/ Outcomes  • Alert me on articles by topic

Erea-Noël Garabedian, MD; Richard Nicollas, MD; Gilles Roger, MD; Jerôme Delattre, MD; Patrick Froehlich, MD, PhD; Jean-Michel Triglia, MD

Arch Otolaryngol Head Neck Surg. 2005;131:505-508.

Objective  To review cricotracheal resection (CTR) in children weighing less than 10 kg.

Design and Setting  Retrospective study of 17 patients (mean follow-up, 23 months) from 3 ear, nose, and throat pediatric centers.

Patients  Seventeen children (10 boys and 7 girls; mean age, 14.6 months; and mean weight, 7.6 kg) undergoing CTR from June 1995 to March 2003.

Main Outcome Measures  Decannulation rates and endoscopies.

Results  The cause was congenital subglottic stenosis in 2 children (12%) and acquired subglottic stenosis in 15 (88%). All but 1 had grade 3 or 4 stenosis. The mean hospitalization duration was 34 days. Single-stage CTR was performed in 11 children (65%), with peroperative decannulation in 7. Extubation of these patients occurred between days 3 and 9. Decannulation of the other 6 patients was performed after a median of 15 days. Sixteen (94%) of the 17 children were decannulated. Four patients required additional carbon dioxide laser treatment for subsequent glottic or subglottic edema or granulomas, but no reintubation was necessary. One child could not be decannulated because of bronchopulmonary disease, and subglottic stenosis recurred. Long-term tracheotomy was avoided in all other patients. Another child died of cardiac disease. All other patients remained free of significant subglottic stenosis at follow-up.

Conclusions  Cricotracheal resection in small children weighing less than 10 kg was a safe and effective procedure for severe subglottic stenosis. To our knowledge, this is the first reported attempt of CTR in this weight category, providing results comparable to those published in older children.

Author Affiliations: Departments of Pediatric Ear, Nose, and Throat, Armand-Trousseau Children’s Hospital, Paris VI University, Assistance Publique–Hôpitaux de Paris, Paris (Drs Garabedian, Roger, and Delattre), La Timone Children’s Hospital, Marseille University, Assistance Publique–Hôpitaux de Marseille, Marseille (Drs Nicollas and Triglia), and Edouard Herriot Hospital, Lyon 1 University, Hospices Civils de Lyon, Lyon (Dr Froehlich), France.