Cricotracheal resection with hilar release for pediatric airway stenosis.

OBJECTIVE: To determine the effectiveness of cricotracheal resection and hilar release for high-grade, long-segment airway stenosis.

DESIGN: We identified 16 patients who underwent cricotracheal resection and hilar release, performed from January 1, 2004, through December 31, 2008, and conducted a retrospective review, emphasizing preoperative findings, operative technique, postoperative course, and results. Complete data sets were available for all patients.

SETTING: Tertiary care children's hospital.

PATIENTS: The study population comprised 16 patients younger than 18 years who underwent cricotracheal resection and hilar release performed by a thoracic airway team. All patients had high-grade, long-segment subglottic stenosis or severe, long-segment tracheomalacia.

INTERVENTION: Cricotracheal resection with hilar release.

MAIN OUTCOME MEASURES: Decannulation rate and dehiscence rate.

RESULTS: Of the 16 patients, 15 were successfully decannulated. The one patient who was not decannulated remained ventilator dependent and has regained speech. There were no incidents of anastomotic dehiscence.

CONCLUSION: Cricotracheal resection with hilar release is a novel and effective way to approach the problem of severe airway stenosis.