Partial cricotracheal resection for severe subglottic stenosis in children

Abstract

Surgical management of pediatric subglottic stenosis remains many challenging tasks to pediatric surgeons and otorhinolaryngologists. The children suffering from Myer-Cotton grade III and IV subglottic stenosis are put in the particularly difficult condition to be treated. The concept of partial cricotracheal resection with primary thyrotracheal anastomosis (PCTR) is to resect the cicatricial stenotic segment of the airway completely and to achieve a fully mucosalized reconstruction using thyrotracheal anastomosis. However, operative techniques and postoperative cares in PCTR for small infants are complicated, PCTR for severe subglottic stenosis in pediatric patients has been reported to have a high decannulation rate.

We performed PCTR in 5 patients with severe subglottic stenosis in children (one with congenital, and the other acquired) as a primary procedure. The silicone T-tube was temporarily used to maintain the airway expanded after surgery. We could successfully decannulate in all patients after surgery.

PCTR with T-tube stenting is one of effective and safe definitive procedures for the patients with severe subglottic stenosis in children.