Drake A F, Babyak J W, Niparko J K, Koopmann C F
Department of Otolaryngology, University of Michigan Medical Center, Ann Arbor.
Arch Otolaryngol Head Neck Surg. 1988 Dec;114(12):1404-6. doi: 10.1001/archotol.1988.01860240054023.
A recommended approach to postextubation infant subglottic stenosis secondary to subglottic edema employs the recently described anterior cricoid split (ACS) procedure. This technique provides an expanded subglottic airway with minimal paratracheal dissection and does not require concomitant tracheotomy. We applied this procedure in managing extubation difficulty in pediatric as well as neonatal patients. Five of ten patients in our series did not fulfill the traditional criteria for ACS. Relief of stridor and avoidance of tracheotomy were accomplished in nine of ten patients. One patient in whom mechanical ventilation was reinstituted developed an interesting complication. In properly selected infants with subglottic airway compromise, the ACS appears to be an effective adjunct in facilitating extubation.
一种针对声门下水肿继发的拔管后婴儿声门下狭窄的推荐方法是采用最近描述的环状软骨前劈开术（ACS）。该技术能以最小的气管旁分离提供扩大的声门下气道，且不需要同时进行气管切开术。我们将此手术应用于处理儿科及新生儿患者的拔管困难。我们系列中的10名患者中有5名不符合ACS的传统标准。10名患者中有9名喘鸣缓解且避免了气管切开术。1名重新进行机械通气的患者出现了一种有趣的并发症。在经过适当选择的有声门下气道受损的婴儿中，ACS似乎是促进拔管的一种有效辅助手段。
