Cricotracheal resection in children

Objective: To review our experience with cricotracheal resection in a pedia tric population. Design: Prospective case review of a cohort of patients undergoing cricotra cheal resection. Setting: Tertiary care pediatric hospital. Patients: Forty-four consecutive patients undergoing cricotracheal resectio n between January 1, 1993, and December 31, 1998. Main Outcome Measures: Decannulation rates. Results: Thirty-eight (86%) of the 44 children are decannulated. The ultima te 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 resec tion, and 19 (90%) are decannulated. Nine children had an extended cricotra cheal resection, of whom 5 (56%) are decannulated. A primary cricotracheal resection was performed on a child on whom no previous open airway procedur e had been performed. A salvage cricotracheal resection was performed on a child on whom previous open airway reconstruction had not resulted in an ad equate 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 procedu re. Most of these children had complex airway pathologic conditions. Conclusion: Cricotracheal resection complements standard laryngotracheal re construction techniques in a pediatric population.