Puri Harsh Vardhan, Bansal Manish, Asaf Belal Bin, Pulle Mohan Venkatesh, Bishnoi Sukhram, Kumar Arvind
Institute of Chest Surgery, Medanta - The Medicity, Room No. 12, 4Th Floor, OPD Block, Sector - 38, Gurugram, 122001 India.
Institute of Heart Sciences, Medanta - The Medicity, Gurugram, India.
Indian J Otolaryngol Head Neck Surg. 2023 Mar;75(1):200-207. doi: 10.1007/s12070-022-03437-y. Epub 2023 Jan 17.
We present herein our results of cricoid augmentation with costal cartilage in complex crico-tracheal stenosis in adults. This is a retrospective analysis of a prospectively maintained data of patients who underwent surgery for crico-tracheal stenosis at a tertiary care centre from March 2012 to September 2019. Finding of subglottic stenosis with cricoid narrowing was taken as an indication for cricoid split and costal cartilage graft augmentation. Their demographic and clinical data, pre-operative work up, intra-operative details and post-operative course was recorded. Ten patients underwent cricoid split with costal cartilage graft augmentation and crico-tracheal anastomosis between March 2012 and November 2019. The mean age was 29 years (range, 22-58 years). There were 6 males (60%) and 4 females (40%). All 10 patients underwent circumferential resection of stenosed tracheal segment, cricoid split, interposition of costal cartilage graft and an anastomosis between augmented cricoid and trachea. Eight patients (80%) anterior cricoid split and 2 (20%) had anterior as well as posterior split. Average resected length of trachea was 2.39 cms. Cricoid split with costal cartilage augmentation is a feasible option to expand cricoid lumen in crico-tracheal stenosis. None except one of our patients required any further intervention in mean follow up of 42 months and all are free from primary symptoms. The functional results of the surgery were also excellent in 90% of the patients.
我们在此展示了在成人复杂性环状软骨-气管狭窄中使用肋软骨进行环状软骨扩大术的结果。这是一项对2012年3月至2019年9月在一家三级医疗中心接受环状软骨-气管狭窄手术患者的前瞻性维护数据进行的回顾性分析。声门下狭窄伴环状软骨狭窄的发现被视为环状软骨劈开和肋软骨移植扩大术的指征。记录了他们的人口统计学和临床数据、术前检查、术中细节和术后病程。2012年3月至2019年11月，10例患者接受了环状软骨劈开、肋软骨移植扩大术和环状软骨-气管吻合术。平均年龄为29岁（范围22 - 58岁）。男性6例（60%），女性4例（40%）。所有10例患者均接受了狭窄气管段的环形切除、环状软骨劈开、肋软骨移植置入以及扩大后的环状软骨与气管之间的吻合术。8例患者（80%）进行了环状软骨前侧劈开，2例（20%）进行了前侧及后侧劈开。气管平均切除长度为2.39厘米。环状软骨劈开加肋软骨扩大术是扩大环状软骨-气管狭窄中环状软骨管腔的一种可行选择。在平均42个月的随访中，除1例患者外，其余患者均无需进一步干预，且所有患者均无主要症状。90%的患者手术功能结果也非常好。
