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An anterior cricoid split and long-term silastic T-tube stenting for children with severe subglottic stenosis.
Pediatr Surg Int. 2020 Jun; 36(6):697-700.PS

Abstract

PURPOSE

The management of subglottic stenosis (SGS) remains challenging. Although laryngotracheal reconstruction with a costal cartilage graft (LTR) has been widely performed, restenosis with cicatricial tissue may require long-term stenting, especially in patients with severe SGS. An anterior cricoid split (ACS) with long-term stenting has been shown to be useful for patients with mild SGS. Thus, we evaluated the clinical outcomes of patients, including severe SGS, who underwent ACS compared to those with LTR.

METHODS

A retrospective chart review was conducted in 25 patients with severe SGS (Grades III and IV) who underwent initial laryngoplasty (ACS or LTR) in our hospital from January 2009 to April 2018.

RESULTS

17 patients (8 with Grade III and 9 with Grade IV) underwent ACS, and 8 (6 with Grade III and 2 with Grade IV) underwent LTR. The median duration of stenting was 11 months (range: 0.8-50) in the ACS group and 12 months (range: 0.4-29) in the LTR group. Thirteen of 17 patients (76.5%) in the ACS group were decannulated, whereas 4 of 8 patients (50%) in the LTR group were decannulated (p = 0.2).

CONCLUSION

ACS might be useful even for children with severe SGS. The optimal duration of stenting should be investigated further.

Authors+Show Affiliations

Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7, Minatojima minamimachi, Chuoku, Kobe, 650-0047, Japan. yokoi_kch@hp.pref.hyogo.jp.Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7, Minatojima minamimachi, Chuoku, Kobe, 650-0047, Japan. Department of Pediatric Surgery, Kakogawa Central City Hospital, Kakogawa, Japan.Department of Pediatric Surgery, Kobe Children's Hospital, 1-6-7, Minatojima minamimachi, Chuoku, Kobe, 650-0047, Japan. Department of Pediatric Surgery, Kobe University Hospital, Kobe, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32322966

Citation

Yokoi, Akiko, et al. "An Anterior Cricoid Split and Long-term Silastic T-tube Stenting for Children With Severe Subglottic Stenosis." Pediatric Surgery International, vol. 36, no. 6, 2020, pp. 697-700.
Yokoi A, Nakao M, Bitoh Y. An anterior cricoid split and long-term silastic T-tube stenting for children with severe subglottic stenosis. Pediatr Surg Int. 2020;36(6):697-700.
Yokoi, A., Nakao, M., & Bitoh, Y. (2020). An anterior cricoid split and long-term silastic T-tube stenting for children with severe subglottic stenosis. Pediatric Surgery International, 36(6), 697-700. https://doi.org/10.1007/s00383-020-04657-5
Yokoi A, Nakao M, Bitoh Y. An Anterior Cricoid Split and Long-term Silastic T-tube Stenting for Children With Severe Subglottic Stenosis. Pediatr Surg Int. 2020;36(6):697-700. PubMed PMID: 32322966.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - An anterior cricoid split and long-term silastic T-tube stenting for children with severe subglottic stenosis. AU - Yokoi,Akiko, AU - Nakao,Makoto, AU - Bitoh,Yuko, Y1 - 2020/04/22/ PY - 2020/04/11/accepted PY - 2020/4/24/pubmed PY - 2020/4/24/medline PY - 2020/4/24/entrez KW - Children KW - Costal cartilage graft KW - Laryngotracheoplasty KW - Subglottic stenosis SP - 697 EP - 700 JF - Pediatric surgery international JO - Pediatr. Surg. Int. VL - 36 IS - 6 N2 - PURPOSE: The management of subglottic stenosis (SGS) remains challenging. Although laryngotracheal reconstruction with a costal cartilage graft (LTR) has been widely performed, restenosis with cicatricial tissue may require long-term stenting, especially in patients with severe SGS. An anterior cricoid split (ACS) with long-term stenting has been shown to be useful for patients with mild SGS. Thus, we evaluated the clinical outcomes of patients, including severe SGS, who underwent ACS compared to those with LTR. METHODS: A retrospective chart review was conducted in 25 patients with severe SGS (Grades III and IV) who underwent initial laryngoplasty (ACS or LTR) in our hospital from January 2009 to April 2018. RESULTS: 17 patients (8 with Grade III and 9 with Grade IV) underwent ACS, and 8 (6 with Grade III and 2 with Grade IV) underwent LTR. The median duration of stenting was 11 months (range: 0.8-50) in the ACS group and 12 months (range: 0.4-29) in the LTR group. Thirteen of 17 patients (76.5%) in the ACS group were decannulated, whereas 4 of 8 patients (50%) in the LTR group were decannulated (p = 0.2). CONCLUSION: ACS might be useful even for children with severe SGS. The optimal duration of stenting should be investigated further. SN - 1437-9813 UR - https://www.unboundmedicine.com/medline/citation/32322966/An_anterior_cricoid_split_and_long-term_silastic_T-tube_stenting_for_children_with_severe_subglottic_stenosis L2 - https://doi.org/10.1007/s00383-020-04657-5 DB - PRIME DP - Unbound Medicine ER -
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