Outcomes of Cricotracheal Resection in Airway Reconstruction for Expanded Indications. (23rd August 2013)

• Record Type: Journal Article
• Authors: Myer, Charles M.; Hart, Catherine K.; Tabangin, Meredith; Heubi, Christine H.; Rutter, Michael J.; Cotton, Robin T.; de Alarcon, Alessandro
• Is Part Of: Otolaryngology--head and neck surgery. Volume 149(2013)Supplement 2
• Page Start: P120
• Page End: P120
• Publication Date: 2013-08-23
• Subjects: Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599813495815a258
• Languages: English
• ISSNs: 0194-5998

Abstract

Abstract : Objectives: 1) Describe expanded indications of cricotracheal resection (CTR) in airway reconstruction, including revision reconstruction and young age. 2) Define outcomes associated with expanded indications of CTR. Methods: Retrospective review of patients undergoing CTR at a tertiary care hospital from January 1, 2005, to December 31, 2011. Primary outcomes included decannulation rates and surgical success, defined as absence of symptoms at last follow‐up. Logistic regression was used to examine age as a predictor of surgical success. Eighty patients were identified, with 68 patients having complete records available for review. Forty‐nine patients were under 21 years of age. Results: In pediatric patients, surgical indications included stenosis (n = 43, 87.76%), A‐frame deformity (n = 5, 10.2%), and laryngeal atresia (n = 1, 2%). Patients with subglottic stenosis (SGS) included 4 (9.3%) grade II, 34 (79.07%) grade III, and 5 (11.63%) grade IV. Thirty‐eight patients (77.55%) were tracheostomy‐dependent. Thirty‐one patients (63.27%) had a history of prior airway surgery. Decannulation was achieved in 40 patients (81.63%); 36 patients (73.47%) were asymptomatic at last follow‐up. Eight patients required additional open operation. Logistic regression analysis of pediatric patients showed over‐all surgical success was associated with increased age ( P =. 02). Success rates between primary surgery and revisions were similar (67% vs. 77%, Fisher's exact test, P =. 51). Conclusions: In our pediatric cohort, we found success of CTR is associated with older age at time of reconstruction. There was no association between success and primary surgery, suggesting CTR remains a viable option in revision cases.