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An anterior cricoid split and long-term silastic T-tube stenting for children with severe subglottic stenosis

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Abstract

Purpose

The management of subglottic stenosis (SGS) remains challenging. Although laryngotracheal reconstruction with a costal cartilage graft (LTR) has been widely performed, restenosis with cicatricial tissue may require long-term stenting, especially in patients with severe SGS. An anterior cricoid split (ACS) with long-term stenting has been shown to be useful for patients with mild SGS. Thus, we evaluated the clinical outcomes of patients, including severe SGS, who underwent ACS compared to those with LTR.

Methods

A retrospective chart review was conducted in 25 patients with severe SGS (Grades III and IV) who underwent initial laryngoplasty (ACS or LTR) in our hospital from January 2009 to April 2018.

Results

17 patients (8 with Grade III and 9 with Grade IV) underwent ACS, and 8 (6 with Grade III and 2 with Grade IV) underwent LTR. The median duration of stenting was 11 months (range: 0.8–50) in the ACS group and 12 months (range: 0.4–29) in the LTR group. Thirteen of 17 patients (76.5%) in the ACS group were decannulated, whereas 4 of 8 patients (50%) in the LTR group were decannulated (p = 0.2).

Conclusion

ACS might be useful even for children with severe SGS. The optimal duration of stenting should be investigated further.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Kobe Children’s Hospital, 1-6-7, Minatojima minamimachi, Chuoku, Kobe, 650-0047, Japan

    Akiko Yokoi, Makoto Nakao & Yuko Bitoh

  2. Department of Pediatric Surgery, Kakogawa Central City Hospital, Kakogawa, Japan

    Makoto Nakao

  3. Department of Pediatric Surgery, Kobe University Hospital, Kobe, Japan

    Yuko Bitoh

Authors
  1. Akiko Yokoi
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  2. Makoto Nakao
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  3. Yuko Bitoh
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Correspondence to Akiko Yokoi.

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Akiko Yokoi and other co-authors have no conflict of interest.

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Yokoi, A., Nakao, M. & Bitoh, Y. An anterior cricoid split and long-term silastic T-tube stenting for children with severe subglottic stenosis. Pediatr Surg Int 36, 697–700 (2020). https://doi.org/10.1007/s00383-020-04657-5

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  • DOI: https://doi.org/10.1007/s00383-020-04657-5

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