Skip to main content
×
×
Home

Endoscopic cricoid split in a tertiary referral paediatric centre

  • S Carr (a1), A Dritsoula (a1) and R Thevasagayam (a1)
Abstract
Background

Anterior cricoid split is performed for grade 2 and 3 subglottic stenosis, which can be a cause of extubation failure. It can be performed endoscopically or as an open procedure. This paper describes a case series of endoscopic cricoid split procedures performed using a bespoke sickle knife.

Method

Nine patients (six pre-term infants) underwent endoscopic cricoid split in a tertiary referral paediatric unit between August 2012 and March 2015.

Results

Six patients (67 per cent; four pre-term and two term infants) were on oxygen pre-operatively. Mean age at operation was 30 weeks (range, 11–104 weeks). Mean number of days’ intubation was 5.6 days (range, 4–9 days). All five patients intubated pre-operatively were extubated. Seven patients required repeat dilatations. One patient required tracheostomy.

Conclusion

The extubation rates for endoscopic cricoid split are comparable to the open procedure. It is a safe and efficient method for managing subglottic stenosis, whether acquired or congenital. The main advantage is the shorter operative time, in addition to the avoidance of an external scar and drain.

Copyright
Corresponding author
Author for correspondence: Mr S Carr, Department of Otolaryngology, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK E-mail: Simoncarr15@gmail.com
Footnotes
Hide All

Mr S Carr takes responsibility for the integrity of the content of the paper

Presented as a poster at the British Academic Conference in Otolaryngology, 8–10 July 2015, Liverpool, and orally at the British Association of Paediatric Otolaryngology, 18 September 2015, Belfast, Northern Ireland, UK.

Footnotes
References
Hide All
1Cotton, RT, Seid, AB. Management of the extubation problem in the premature child: anterior cricoid split as an alternative to tracheotomy. Ann Otol Rhinol Laryngol 1980;89:508–11
2Tweedie, DJ, Skilbeck, CJ, Cochrane, LA, Cooke, J, Wyatt, ME. Choosing a paediatric tracheostomy tube: an update on current practice. J Laryngol Otol 2008;122:161–9
3Pashley, NR. Anterior cricoidotomy for congenital and acquired subglottic stenosis in infants and children. J Otolaryngol 1984;13:187–90
4Seid, AB, Canty, TG. The anterior cricoid split procedure for the management of subglottic stenosis in infants and children. J Pediatr Surg 1985;20:388–90
5Holinger, LD, Stankiewicz, JA, Livingston, GL. Anterior cricoid split: the Chicago experience with an alternative to tracheostomy. Laryngoscope 1987;97:1924
6Anderson, GJ, Tom, LW, Wetmore, RF, Handler, SD, Potsic, WP. The anterior cricoid split: the Children's Hospital of Philadelphia experience. Int J Pediatr Otorhinolaryngol 1988;16:31–8
7Rotenberg, BW, Berkowitz, RG. Changing trends in the success rate of anterior cricoid split. Ann Otol Rhinol Laryngol 2006;115:833–6
8Mirabile, L, Serio, P, Baggi, R, Couloigner, V. Endoscopic anterior cricoid split and balloon dilation in pediatric subglottic stenosis. Int J Pediatr Otorhinolaryngol 2010;74:1409–14
9Horn, DL, Maguire, RC, Simons, JP, Mehta, DK. Endoscopic anterior cricoid split with balloon dilation in infants with failed extubation. Laryngoscope 2012;122:216–19
10Silver, FM, Myer, CM 3rd, Cotton, RT. Anterior cricoid split. Update 1991. Am J Otolaryngol 1991;12:343–6
11Walker, P, Forte, V. Failed extubation in the neonatal intensive care unit. Ann Otol Rhinol Laryngol 1993;102:489–95
12Matute, JA, Villafruela, MA, Delgado, MD, Berchi, FJ, Vazquez, J. Surgery of subglottic stenosis in neonates and children. Eur J Pediatr Surg 2000;10:286–90
13Eze, NN, Wyatt, ME, Hartley, BE. The role of the anterior cricoid split in facilitating extubation in infants. Int J Pediatr Otorhinolaryngol 2005;69:843–6
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score