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Endoscopic cricoid split in a tertiary referral paediatric centre

Published online by Cambridge University Press:  16 July 2018

S Carr ,
A Dritsoula  and
R Thevasagayam
S Carr*
Affiliation:
Department of Otolaryngology, Sheffield Children's Hospital, UK
A Dritsoula
Affiliation:
Department of Otolaryngology, Sheffield Children's Hospital, UK
R Thevasagayam
Affiliation:
Department of Otolaryngology, Sheffield Children's Hospital, UK
*
Author for correspondence: Mr S Carr, Department of Otolaryngology, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK E-mail: Simoncarr15@gmail.com
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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.

Keywords

Acquired Subglottic StenosisCongenital Subglottic StenosisEndoscopySurgery
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 8 , August 2018 , pp. 753 - 756
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

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.

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