Use of the anterior cricoid split operation in infants with acquired subglottic stenosis.

Abstract:

:Ten infants with acquired subglottic stenosis were treated successfully using the anterior cricoid split operation. Eight had been preterm infants who required endotracheal intubation and assisted ventilation for the respiratory distress syndrome. Two had been born at term; 1 required mechanical ventilation for aspiration of meconium and the other intubation for obstructive apnea. All had been extubated successfully in less than 2 wk and were discharged home with no signs of subglottic stenosis. These infants were referred at 2 to 13 months of age for evaluation of upper airway obstruction. By bronchoscopy, we confirmed severe subglottic stenosis in each of the infants. The anterior cricoid split procedure requires a single midline vertical incision through the anterior cartilaginous ring of the cricoid cartilage and the upper 2 tracheal rings. Our postoperative management included 7 to 10 days of endotracheal intubation, mechanical ventilation, neuromuscular blockade, sedation, and total parenteral nutrition. All were extubated at the end of this period without evidence of stridor or obstructive apnea. One patient developed a subglottic granuloma at the level of the cricoid cartilage 4 months after the operation; this was successfully excised with the carbon dioxide laser. The other 9 patients remain asymptomatic 1 month to 1 yr after the surgical repair.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Frankel LR,Anas NG,Perkin RM,Seid AB,Peterson B,Park SM

doi

10.1097/00003246-198404000-00012

subject

Has Abstract

pub_date

1984-04-01 00:00:00

pages

395-8

issue

4

eissn

0090-3493

issn

1530-0293

journal_volume

12

pub_type

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