Cricotracheal Resection in Children

Rutter, Michael J.; Hartley, Benjamin E. J.; Cotton, Robin T.

doi:10.1001/archotol.127.3.289

Cited by 106 publications

(99 citation statements)

References 10 publications

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“…Expansion framework procedures involve the use of anterior and/or posterior grafts (from the rib, thyroid or conchal cartilages) placed between the edges of a surgically created split in the anterior and/or posterior lamina of the cricoid cartilage. Resection procedures are used for more severe stenosis (Grades III or IV), and involve removal of the stenotic subglottic/tracheal region with reapproximation of the healthy tracheal segment to the posterior cricoid remnant and thyroid lamina [3,13]. Depending upon the location and extent of stenosis, surgical intervention may be a single stage procedure involving reconstruction with intra-operative closure of the tracheostoma, or as a staged procedure requiring the tracheostomy to be maintained during the post-operative healing period.…”

mentioning

confidence: 99%

Duration and extent of dysphagia following pediatric airway reconstruction

Miller

Linck

Willging

2009

International Journal of Pediatric Otorhinolaryngology

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mentioning

confidence: 99%

Duration and extent of dysphagia following pediatric airway reconstruction

Miller

Linck

Willging

2009

International Journal of Pediatric Otorhinolaryngology

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“…Diese Angaben stammen aus Zentren, die überwiegend mit der Cotton-Technik arbeiten bzw.gearbeitet haben.Sollte sich die PCTR nach Monnier gerade für die hochgradigen Stenosen noch stärker durchsetzen,ist mit einer weiteren Verbesserung der primären Erfolgsergebnisse zu rechen, denn die jüngsten Erfolgsquoten nach krikotrachealer Resektion liegen in Abhängigkeit von der Ausgangssituation zwischen 70 und 97% [17,30].…”

Section: Prognoseunclassified

Management von Postintubationsstenosen bei Kindern

Schultz-Coulon

2004

HNO

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Extubation difficulties after long-term endotracheal intubation in neonates and infants require immediate re-intubation with a somewhat thinner endotracheal tube, continuation of long-term intubation for another 7-14 days with antibiotic and antiphlogistic therapy including antireflux treatment as well as a subtile endoscopic examination. A tracheostomy is not indicated before several attempts of extubation have failed. An anterior cricoid split should be indicated with great care and in premature neonates only. In manifest cicatrical stenoses, subtile endoscopic diagnostics are an essential prerequisite for the choice of surgical method and time of surgery. In rather mild stenoses (grade II), laryngotracheal reconstruction (LTR) with anterior wall cartilage grafting is presently regarded as method of choice. For subglottic stenoses of higher degrees (grade III and IV), partial cricotracheal resection (PCTR) is felt to be the most successful procedure. For all scarred stenoses involving the glottic level, LTR with posterior and anterior wall cartilage grafting appears to be the only suitable treatment. LTR with anterior wall grafting only as well as the PCTR can be performed as a single stage procedure with postoperative long-term intubation on an intensive care unit for one or more days. LTR with posterior and anterior wall grafting requires long-term stenting for several weeks or months depending upon the individual condition. For long-term stenting, our so-called double-tube-technique using a modified Montgomery T silicon tube together with a perforated tracheal cannula has proved to be the safest and least irksome technique.

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“…Recently, interest has turned toward cricotracheal resection in children [14][15][16][17]. This procedure has enabled a number of patients, who may not have been successfully treated with a SSLTR secondary to severe disease, to be decannulated.…”

Section: Introductionmentioning

confidence: 99%

“…This procedure has enabled a number of patients, who may not have been successfully treated with a SSLTR secondary to severe disease, to be decannulated. Much like laryngotracheal reconstruction (LTR), this procedure can consist of a two-staged procedure with stenting or a single-staged procedure with the use of an endotracheal tube as a stent for 7-10 days [16]. Summary Major airway surgery in children has traditionally consisted of a period of endotracheal intubation after the procedure for a period of 1-2 weeks to ensure stability of the repair.…”

Section: Introductionmentioning

confidence: 99%