Partial cricotracheal resection for paediatric subglottic stenosis: update of the Lausanne experience with 129 cases

Yamamoto, Kazumichi; Jaquet, Yves; Ikonomidis, Christos; Monnier, Philippe

doi:10.1093/ejcts/ezu273

Cited by 35 publications

(32 citation statements)

References 22 publications

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“…The rate of reoperation is between 22-45% after LTR. 4,11,[13][14][15]18,19,22,25,28 All of the presented cases included high grade, cartilaginous, concentric stenoses. Accordingly, no endoscopic interventions, but external approach was preferred.…”

Section: Discussionmentioning

confidence: 97%

“…Because of the above‐mentioned difficulties, a definitive surgical solution is usually delayed for years, although an early tracheostomy is often unavoidable . The most common surgical solutions (CTR/ECTR, PCTR, LTR) are recommended in general from the age of 1 year . The youngest PCTR patient described was a 1‐month‐old infant without any comorbidity .…”

Section: Discussionmentioning

confidence: 99%

“…However, even though the overall decannulation rate after CTR is over 80% ‐ the rate of reoperation is between 4–41%, depending on the grade of the stenosis and the comorbidities. The rate of reoperation is between 22–45% after LTR …”

Section: Discussionmentioning

confidence: 99%

“…[21][22][23][24] The most common surgical solutions (CTR/ECTR, PCTR, LTR) are recommended in general from the age of 1 year. 4,11,14,15,[21][22][23][24][25][26][27] The youngest PCTR patient described was a 1-month-old infant without any comorbidity. 22 However, even though the overall decannulation rate after CTR is over 80% -the rate of reoperation is between 4-41%, depending on the grade of the stenosis and the comorbidities.…”

Section: Discussionmentioning

confidence: 99%

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Slide laryngotracheoplasty for congenital subglottic stenosis in newborns and infants

et al. 2019

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Objectives Subglottic stenosis is the most common laryngeal anomaly necessitating tracheostomy in early childhood. Crico‐ and laryngotracheal resection and laryngotracheal reconstruction—usually with autologous cartilage graft implantation—are the most effective treatments. These surgical techniques are obviously challenging in neonatal age and infancy. However, a reconstructive surgery performed at early age may prevent the sequel of complications. Methods The authors present their novel surgical method for congenital subglottic stenosis. Seven infants had inspiratory stridor; two of them had to be intubated and one required tracheostomy. Laryngotracheoscopy, CT or MRI revealed subglottic stenosis: Cotton‐Myer grade II in one, and grade III in six cases. Slide laryngotracheoplasty was performed before 5 months of age (10–130 days), with a follow‐up period of average 36 months (4–80 months). Phoniatry and quality of life questionnaire were used for evaluation of postoperative results. Results Slide laryngotracheoplasty in the neonatal age made the temporary tracheostomy unnecessary. All babies remained intubated for 3 to 10 days with an uncuffed tracheal tube. After extubation, no dyspnea or swallowing disorder occurred. A subjective quality of life questionnaire, laryngotracheoscopy, clinical growth charts showed satisfactory functional results. Conclusions Single‐stage slide laryngotracheoplasty might be a favorable solution for subglottic stenosis, even in early childhood. In one step, the airway can be maintained without stenting and tracheostomy. Level of Evidence 4 Laryngoscope, 130:E199–E205, 2020

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Slide laryngotracheoplasty for congenital subglottic stenosis in newborns and infants

et al. 2019

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“…In pediatric patients, laryngotracheal reconstructions represent an established and frequently applied technique, with series of more than 100 patients reported from Lausanne and Cincinnati. 7,8 In this population, the cartilage grafts are trimmed with lateral flanges and sutured with 6-0 sutures to the two halves of the split cricoid plate. 9 This maneuver leads to an immediately stable reconstruction of the naturally floppy pediatric airway.…”

Section: See Editorial Commentary Page 1018mentioning

confidence: 99%

A modified technique of laryngotracheal reconstruction without the need for prolonged postoperative stenting

Höetzenecker

Schweiger

Roesner

et al. 2016

The Journal of Thoracic and Cardiovascular Surgery

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Myer‐Cotton Grade of Subglottic Stenosis Depends on Style of Endotracheal Tube Used

Propst

Wolter

2023

The Laryngoscope

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ObjectivesDetermine percentage of subglottic stenosis using current endotracheal tube (ETT) cross‐sectional areas as actual, compared with previously published ETT cross‐sectional areas as expected, and determine if style of ETT could result in a change in percentage of stenosis or Myer‐Cotton grade.Study TypeCross‐sectional study.DesignProspective analysis.MethodsEight styles of uncuffed pediatric ETT from four manufacturers ranging from 2.0 to 6.0 inner diameter (ID) were evaluated. ID and outer diameter (OD) measurements were obtained from each company's specification sheets. Cross‐sectional area was calculated for each ETT using the formula (Area = πr2). The cross‐sectional areas of each current ETT (actual) were compared with those of previously published ETTs (expected) based on age, and the degree of stenosis was calculated using the formula [1‐ (Area actual/Area expected)] × 100%. Ranges of percentage for each style of ETT were calculated.ResultsThere was an increase in range of OD and area with increasing size of ETT ID, with the largest range in OD being 0.8 mm, and the largest range in area being 10.55 mm2. The median interquartile range (IQR), range of percentage stenoses was 11 (5%), ranging from 0% to 21%. Seven of 28 (25%) ranges were found to span two Myer‐Cotton grades.ConclusionsThe Myer‐Cotton grade of subglottic stenosis depends on the style of ETT used. Using updated values from currently available ETTs aims to keep this grading system valid with respect to surgical approach and outcomes following surgery.Level of EvidenceNA Laryngoscope, 133:2808–2812, 2023

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Partial cricotracheal resection for paediatric subglottic stenosis: update of the Lausanne experience with 129 cases

Cited by 35 publications

References 22 publications

Slide laryngotracheoplasty for congenital subglottic stenosis in newborns and infants

Slide laryngotracheoplasty for congenital subglottic stenosis in newborns and infants

A modified technique of laryngotracheal reconstruction without the need for prolonged postoperative stenting

Myer‐Cotton Grade of Subglottic Stenosis Depends on Style of Endotracheal Tube Used

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