The anterior cricoid split explored via the canine model, preliminary studies.

Since Cotton and Seid introduced a new surgical procedure, the anterior cricoid split in 1980, the treatment of the difficult-to-extubate infant or child has changed dramatically. The mechanics of how the procedure works are poorly understood. This study was undertaken to investigate the effects of the anterior cricoid split on the cricoid cartilage. The technique was modified so as to allow placement and maintenance of an endotracheal tube but still allow normal activity in the canine subjects. Australian Shepherd puppies were divided into 3 groups. Group 1 underwent the anterior cricoid split procedure with placement of an endotracheal tube stent, Group 2 underwent the anterior cricoid split procedure without the use of a stent, and Group 3 served as controls. All animals were sacrificed at 12 weeks of age. The results show that there was an actual gap in the cricoid cartilage in all animals that underwent the anterior cricoid split procedure. Stenting with an endotracheal tube significantly increased this gap. These results suggest that in the canine model the anterior cricoid split may be used to actually increase the size of the subglottic space.