Anterior–posterior cricoid split combined with silastic T-tube stenting for subglottic stenosis in children: a single surgeon’s experience

• Published in: Pediatric surgery international Vol. 34; no. 10; pp. 1041 - 1046
• Main Authors: Bitoh, Yuko, Okata, Yuichi, Tsugawa, Jiro, Miyauchi, Harunori, Aida, Yosuke, Tachibanaki, Yumiko, Nakai, Yumiko, Tomioka, Yuichiro
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2018; Springer Nature B.V
• Subjects: Bronchoscopy - methods; Child; Child, Preschool; Clinical outcomes; Cricoid Cartilage - diagnostic imaging; Cricoid Cartilage - surgery; Device Removal; Female; Humans; Laryngostenosis - diagnostic imaging; Laryngostenosis - surgery; Male; Medicine; Medicine & Public Health; Original Article; Ostomy; Pediatric Surgery; Pediatrics; Postoperative Period; Retrospective Studies; Severity of Illness Index; Stents; Surgery; Treatment Outcome; T-tube; Children; Stent; Subglottic stenosis; Cricoid split
• ISSN: 0179-0358; 1437-9813
• DOI: 10.1007/s00383-018-4328-z

Purpose Treatment strategies and clinical outcomes of subglottic stenosis (SGS) in children are varied due to the degree and range of stenotic lesions. The optimal surgical procedure for SGS in children is still under debate. The aim of this study was to evaluate the clinical outcomes of our anterior–posterior cricoid (APC) split technique combined with long-term T-tube stenting for grade II or III SGS in children. Methods A retrospective chart review of children with SGS between January 2011 and December 2016 was conducted. APC split was performed via open procedure under rigid bronchoscopy. After splitting, a silastic T-tube was inserted as a stent and removed 6 months postoperatively. Results Seven children underwent APC split during the period. All children had undergone previous tracheostomy, and APC split was performed when the children were 3–9 years old without any intraoperative complications. Median duration of T-tube stenting was 11 months, and all children were decannulated successfully. There were T-tube-related complications, including two tube-tip granulation that required intervention and one accidental T-tube removal. Conclusion APC split is a technically simple and reproducible procedure, and it could be employed as an optimal procedure for SGS in children.