ANTERIOR CRICOID SPLIT - USE OF HYOID AS AUTOLOGOUS GRAFTING MATERIAL

Objective: To examine the use of hyoid as a readily available autologo us grafting material for the anterior cricoid split (ACS) procedure. D esign: Prospective analysis of 20 patients undergoing ACS with hyoid i nterposition grafting for subglottic stenosis over a 3-year period. Th e patients received at least 1 year of follow-up after surgery. Settin g: Tertiary care children's hospital. Patients: Twenty infants (age ra nge, 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 succes sful extubation. The 8 patients with symptoms of strider and atypical croup showed marked improvement in their symptoms. Serial bronchoscopy revealed mucosal healing and incorporation of the hyoid grafts. Concl usion: Hyoid provides a readily available and reliable grafting materi al for interposition grafting in the ACS procedure for neonates and in fants.