International Journal of Head and Neck Surgery

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VOLUME 12 , ISSUE 2 ( April-June, 2021 ) > List of Articles

Original Article

Clinical Outcomes in Partial Cricotracheal Resection and Anastomosis in Subglottic and Upper Tracheal Stenosis: A 10-year Institutional Study

Izhak Mehadi

Citation Information : Mehadi I. Clinical Outcomes in Partial Cricotracheal Resection and Anastomosis in Subglottic and Upper Tracheal Stenosis: A 10-year Institutional Study. Int J Head Neck Surg 2021; 12 (2):48-50.

DOI: 10.5005/jp-journals-10001-1416

License: CC BY-NC 4.0

Published Online: 01-06-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Aim and objective: The study aimed to review the clinical and surgical outcomes of partial cricotracheal resection (PCTR) and anastomosis in the management of laryngotracheal stenosis (LTS). Materials and methods: The study used a retrospective analysis of adult patients managed in a University Hospital who underwent PCTR and anastomosis from 2007 to 2017. Results: During the 10 years, 53 patients were diagnosed with cricotracheal or tracheal stenosis. Prolonged orotracheal intubation and blunt trauma were the leading causes of upper LTS. The stenosis were classified as per Myer-Cotton classification. Thirty-seven were chosen for surgical intervention. Of the patients who underwent surgical intervention, PCTR was done in 33, resection and anastomosis in 3 and 1 underwent balloon dilatation. Tube displacement and surgical emphysema were the most common complication seen postoperatively. Ninety-seven percent of the patients who underwent surgery were successfully decannulated. Conclusion: Partial cricotracheal resection is an established surgical procedure with low morbidity and mortality. Risk factors for increased morbidity include diabetes mellitus (DM), lengthy resection, and children. Rib autograft was found to be ideal for reconstruction. Prompt observation and intervention of morbidity is the key to good clinical outcomes.

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  1. Har-El G, Shaha A, Chaudry R, et al. Resection of tracheal stenosis with end-to-end anastomosis. Ann Otol Rhinol Loryngol 1993;102(9):670–674. DOI: 10.1177/000348949310200904.
  2. Myer 3rd CM, O’Connor DM, Cotton RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol 1994;103(4 Pt 1):319–323. DOI: 10.1177/000348949410300410.
  3. Marques P, Leal L, Spratley J, et al. Tracheal resection with primary anastomosis: 10 years experience. Am J Otolaryngol 2009;30(6):415–418. DOI: 10.1016/j.amjoto.2008.08.008.
  4. El-Fattah AMA, Ebada HA, Amer HE, et al. Partial cricotracheal resection for severe upper tracheal stenosis: potential impacts on the outcome. Auris Nasus Larynx 2018;45(1):116–122. DOI: 10.1016/j.anl.2017.03.014.
  5. Gozen ED, Yener M, Erdur ZB, et al. End-to-end anastomosis in the managementof laryngotracheal defects. J Laryngol Otol 2017;131(5):447–454. DOI: 10.1017/S0022215117000378.
  6. Pookamala S, Kumar R, Thakar A, et al. Laryngotracheal stenosis: clinical profile, surgical management and outcome. Indian J Otolaryngol Head Neck Surg 2014;66(Suppl 1):198–202. DOI: 10.1007/s12070-011-0424-2.
  7. Sharpe DA, Dixon K, Moghissi K. Endoscopic laser treatment for tracheal obstruction. Eur J Cardiothorac Surg 1996;10(9):722–726. DOI: 10.1016/S1010-7940(96)80331-9.
  8. Auchincloss HG, Wright CD. Complications after tracheal resection and reconstruction: prevention and treatment. J Thorac Dis 2016;8(Suppl 2):S160–S167.
  9. Piazza C, Del Bon F, Paderno A, et al. Complications after tracheal and cricotracheal resection and anastomosis for inflammatory and neoplastic stenoses. Ann Otol Rhinol Laryngol 2014;123(11):798–804. DOI: 10.1177/0003489414538764.
  10. Monnier P, Lang F, Savary M. Partial cricotracheal resection for severe pediatric subglottic stenosis: update of the lausanne experience. Ann Otol Rhinol Laryngol 1998;107(11 Pt 1):961–968. DOI: 10.1177/000348949810701111.
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