Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-18T21:37:20.926Z Has data issue: false hasContentIssue false

Anterior cricoid split procedure with transposition of cricoid cartilage segment

Published online by Cambridge University Press:  02 March 2009

J K Cho
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, SeoulSouth Korea
M H Ko
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, SeoulSouth Korea
J Ryu
Affiliation:
Head and Neck Oncology Clinic, Center for Special Organs, National Cancer Center, Ilsan, South Korea
H-S Jeong*
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, SeoulSouth Korea
*
Address for correspondence: Dr Han-Sin Jeong, Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ir-Won Dong, Kang-Nam Gu, Seoul, 135-710, South Korea. Fax: 82 2 3410 6987, E-mail: hansin.jeong@samsung.com

Abstract

Objective:

In order to improve the outcome and to reduce the post-operative care burden following the anterior cricoid split procedure, we modified the procedure to involve splitting only the cricoid cartilage, not the mucosa deep to the cartilage. In addition, we transposed the cricoid cartilage segment after division of the cricoid ring in the midline.

Case report:

We present the use of our modification in a 19-month-old boy with early-stage subglottic stenosis.

Results:

The technique was performed in one surgical field, and the graft material obtained had the same thickness as the cricoid cartilage. Because there was no intraluminal break, this procedure allowed the patient to avoid the complications of prolonged stenting, and resulted in more rapid extubation.

Conclusion:

The anterior cricoid split procedure with transposition of the cricoid cartilage segment may be a useful treatment option for early-stage subglottic stenosis, with improved outcomes and a reduced post-operative care burden.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Rethi, A. An operation for cicatricial stenosis of the larynx. J Laryngol Otol 1956;70:283–93CrossRefGoogle ScholarPubMed
2 Cotton, RT. Prevention and management of laryngeal stenosis in infants and children. J Pediatr Surg 1985;20:845–51CrossRefGoogle ScholarPubMed
3 Cotton, RT, Seid, AB. Management of the extubation problem in the premature child. Anterior cricoid split as an alternative to tracheotomy. Ann Otol Rhinol Laryngol 1980;89:508–11CrossRefGoogle ScholarPubMed
4 Anderson, GJ, Tom, LW, Wetmore, RF, Handler, SD, Potsic, WP. The anterior cricoid split: the Children's Hospital of Philadelphia experience. Int J Pediatr Otorhinolaryngol 1988;16:31–8CrossRefGoogle ScholarPubMed
5 Holinger, LD, Stankiewicz, JA, Livingston, GL. Anterior cricoid split: the Chicago experience with an alternative to tracheotomy. Laryngoscope 1987;97:1924CrossRefGoogle ScholarPubMed
6 Eze, NN, Wyatt, ME, Hartley, BE. The role of the anterior cricoid split in facilitating extubation in infants. Int J Pediatr Otorhinolaryngol 2005;69:843–6CrossRefGoogle ScholarPubMed
7 Grundfast, KM, Coffman, AC, Milmoe, G. Anterior cricoid split: a “simple” surgical procedure and a potentially complicated care problem. Ann Otol Rhinol Laryngol 1985;94:445–9CrossRefGoogle Scholar
8 de Jong, AL, Park, AH, Raveh, E, Schwartz, MR, Forte, V. Comparison of thyroid, auricular, and costal cartilage donor sites for laryngotracheal reconstruction in an animal model. Arch Otolaryngol Head Neck Surg 2000;126:4953CrossRefGoogle ScholarPubMed
9 Park, AH, Forte, V. Effect of harvesting autogenous laryngeal cartilage for laryngotracheal reconstruction on laryngeal growth and support. Laryngoscope 1999;109:307–11CrossRefGoogle ScholarPubMed
10 Fayoux, P, Vachin, F, Merrot, O, Bernheim, N. Thyroid alar cartilage graft in paediatric laryngotracheal reconstruction. Int J Pediatr Otorhinolaryngol 2006;70:717–24CrossRefGoogle ScholarPubMed
11 Forte, V, Chang, MB, Papsin, BC. Thyroid ala cartilage reconstruction in neonatal subglottic stenosis as a replacement for the anterior cricoid split. Int J Pediatr Otorhinolaryngol 2001;59:181–6CrossRefGoogle ScholarPubMed