Cricotracheal resection with hilar release for pediatric airway stenosis.

OBJECTIVE

To determine the effectiveness of cricotracheal resection and hilar release for high-grade, long-segment airway stenosis.

DESIGN

We identified 16 patients who underwent cricotracheal resection and hilar release, performed from January 1, 2004, through December 31, 2008, and conducted a retrospective review, emphasizing preoperative findings, operative technique, postoperative course, and results. Complete data sets were available for all patients.

SETTING

Tertiary care children's hospital.

PATIENTS

The study population comprised 16 patients younger than 18 years who underwent cricotracheal resection and hilar release performed by a thoracic airway team. All patients had high-grade, long-segment subglottic stenosis or severe, long-segment tracheomalacia.

INTERVENTION

Cricotracheal resection with hilar release.

MAIN OUTCOME MEASURES

Decannulation rate and dehiscence rate.

RESULTS

Of the 16 patients, 15 were successfully decannulated. The one patient who was not decannulated remained ventilator dependent and has regained speech. There were no incidents of anastomotic dehiscence.

CONCLUSION

Cricotracheal resection with hilar release is a novel and effective way to approach the problem of severe airway stenosis.