Cricotracheal resection for adult and pediatric subglottic stenoses: Similarities and differences

Details

Serval ID
serval:BIB_AE7A222B6609
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cricotracheal resection for adult and pediatric subglottic stenoses: Similarities and differences
Journal
Operative Techniques in Otolaryngology-Head and Neck Surgery
Author(s)
Monnier P., Lang F., Savary M.
ISSN
1557-9395
ISSN-L
1043-1810
Publication state
Published
Issued date
1999
Volume
10
Number
4
Pages
311-315
Language
english
Abstract
Since the mid-1970s thoracic surgeons have used cricotracheal resection (CTR) in the adult population. Similar positive results have from then on been reported by different investigators using this technique. In contrast, otolaryngologists have typically used an anterior midline approach to the larynx and trachea for their laryngotracheal reconstructions (LTRs), both in adults and children. The fear of injury to the recurrent laryngeal nerve (RLN), the risk of a dehiscence of the anastomosis, and the interference with normal growth of the larynx in the pediatric age group were the main reasons put forward for not using a CTR for the cure of subglottic stenosis. In this article, we describe the similarities and differences in CTRs performed for adult and pediatric cases. The high rate (>90%) of success for severe pediatric SGS using CTR compares most favorably with LTR, which is still used in most otolaryngology departments. The reasons lie in the full resection of the stenosis and the restoration of a steady cartilaginous framework of the larynx and trachea with full mucosal lining on both sides of the anastomosis. Furthermore, CTR can be associated with a Rethi procedure for the cure of combined posterior glottic and subglottic stenoses. Good results from series of two different centers suggest that CTR will become the treatment of choice for pediatric severe SGS, as is presently the case in the adult population.
Create date
02/05/2013 14:34
Last modification date
20/08/2019 16:18
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