Subglottic stenosis is a common problem that often results from ventilatory support necessary in the premature infant. Previous methods of treatment include tracheostomy with dilatation of the stenosis, steroid injections, and procedures to stent the trachea. Results of these methods have been unsatisfactory because of the multiple procedures needed to obtain an adequate airway as well as the high mortality from long-term tracheostomy in infants. In the past 2 years, seven infants have undergone an anterior cricoid split for tight subglottic stenosis and airway obstruction. Of the seven patients, six were premature, five of whom required ventilatory support ranging from 4 to 30+ days. Each child presented in respiratory distress with symptoms present in five children from 1 to 11 months (mean 3.8) after birth. Bronchoscopy identified the site of obstruction in each case as subglottic, with a narrow lumen, usually less than 2.5 mm in diameter. Anterior cricoid split was performed at ages ranging from 2 to 11 months (mean 5.0). All children were extubated at 10 to 14 days and subsequently discharged home asymptomatic; none required postoperative tracheostomy. Complications developed in five children, including atelectasis, otitis media, phlebitis, and tracheocutaneous fistula in two, one of whom required operative closure. One child was rebronchoscoped at 3 weeks postoperatively for bronchospasm, which resolved on aminophylline. The subglottic trachea was normal. At follow-up ranging from 2 to 21 months (mean 8.3), no child has symptoms referrable to the subglottic region. In one patient, a brief period of respiratory distress recurred 3 months postoperatively due to tracheomalacia.(ABSTRACT TRUNCATED AT 250 WORDS)
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http://dx.doi.org/10.1016/s0022-3468(87)80617-6 | DOI Listing |
Eur J Cardiothorac Surg
December 2024
Department of Thoracic Surgery, Sant'Andrea Hospital-Sapienza University, Rome, Italy.
Objectives: Idiopathic subglottic stenosis (ISS) is an airway stricture between larynx and trachea, within 1 cm from the vocal cords. Resection-reconstruction present technical issues because of the need to resect the anterior portion of the cricoid cartilage, but not the posterior plate beyond which the recurrent laryngeal nerves access the vocal cords. The main surgical challenge consists of the minute airway calibre short below the cords, ensuing after the resection.
View Article and Find Full Text PDFWorld Neurosurg
November 2024
University of Cincinnati College of Medicine, Cincinnati, Ohio, USA; Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Interest in the relational anatomy of the anterior neck among spine surgeons increased after the popularization of anterior cervical discectomy and fusion in the 1950s. Five surface landmarks and their relationship to specific spinal levels have been routinely described, comprising the angle of the mandible for the C2-C3 interspace, the hyoid bone for the C3 body, the thyroid cartilage for the C4-C5 disc, and the cricoid cartilage and carotid tubercle for the C6 body. We aimed to investigate the origins of these anatomic relationships and their application in modern practice.
View Article and Find Full Text PDFJ Voice
October 2024
Department of Anesthesiology, Acıbadem Kozyatağı Hospital, Ondokuz Mayıs Mah. Begol̥nya Sokak. No:12, Kadıköy/İstanbul, Türkiye. Electronic address:
Objective: The aim of this study was to measure laryngeal dimensions in a sample of Turkish cadavers, including males and females of various ages and heights.
Materials And Methods: Morphological measurement was performed on 102 laryngeal specimens. Hyoid bone and laryngeal cartilages were removed from human cadavers.
Int J Pediatr Otorhinolaryngol
November 2024
Department of Family and Community Medicine, Faculty of Medicine Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.
Objective: This systematic review and meta-analysis evaluated the efficacy of various glottic widening procedures (GWPs) in avoiding tracheostomy in infants with bilateral vocal cord paralysis (BVCP).
Methods: A systematic literature search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library from inception to July 2023, without any timeframe limitations. Studies reporting GWPs (Endoscopic anterior-posterior cricoid split, Botox injection, suture lateralization, and other procedures including laser posterior cordotomy/arytenoidectomy) in infants with BVCP were included.
OTO Open
September 2024
Department of Otolaryngology-Head and Neck Surgery King Saud University Medical City, College of Medicine, King Saud University Riyadh Kingdom of Saudi Arabia.
Objective: The objective of our study was to document the feasibility of a novel endoscopic anterior cricoid split and rib grafting technique in a goat airway model.
Study Design: Feasibility pilot animal study.
Setting: Animal surgical laboratory at a tertiary hospital and research center.
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