Slide thyrocricotracheoplasty for the treatment of high-grade subglottic stenosis in children

Abstract

BACKGROUND/PURPOSE: The aim of this study was to describe our early experiences with a novel surgical procedure, "slide thyrocricotracheoplasty," for the treatment of high-grade subglottic stenosis in children.

PATIENTS AND METHODS: A retrospective analysis was performed in 7 children who underwent slide thyrocricotracheoplasty for high-grade subglottic stenosis from 1996 to 2009.

RESULTS: Three patients were male and four were female. The etiology of subglottic stenosis was congenital (n = 4) or acquired (n = 3). All patients had undergone a tracheostomy before slide thyrocricotracheoplasty. Median age at operation was 16 months (range, 1-25 months). The median follow-up period after definitive operation was 58 months (range, 13-156 months). There was one case requiring debridement and re-anastomosis of slide thyrocricotracheoplasty site because of anastomotic disruption caused by a methicillin-resistant Staphylococcus aureus infection of the cartilage and one case requiring a minor operation to remove granulation tissue. At final follow-up, all patients did not have any airway cannulation with satisfactory functional outcome in terms of breathing and swallowing. All except one were noted to have acceptable vocal function. The patient with unsatisfactory vocal function continued to receive voice rehabilitation treatment.

CONCLUSIONS: Slide thyrocricotracheoplasty offers an efficient surgical treatment option with minimal morbidity for high-grade subglottic stenosis in children.