Cricotracheal resection for airway reconstruction: The Sheba Medical Center experience.

Abstract

BACKGROUND:

Intubation and tracheostomy are the most common causes of benign acquired airway stenosis. Management varies according to different conceptions and techniques.

OBJECTIVES:

To review our experience with cricotracheal resection and to assess related pitfalls and complications.

METHODS:

We examined the records of all patients who underwent CTR in a tertiary referral medical center during the period January 1995 to April 2005.

RESULTS:

The study included 61 patients (16 women and 45 men) aged 15-81 years. In 17 patients previous interventions had failed, mostly dilatation and T-tube insertion. Complete obstruction was noted in 19 patients and stenosis > 70% in 26. Concomitant lesions included impaired vocal cord mobility (n=8) and tracheo-esophageal fistula (n=5). Cricotracheal anastomosis was performed in 42 patients, thyrotracheal in 12 and tracheotracheal in 7. A staged procedure was planned for quadriplegic patients and for three others with bilateral impaired vocal cord mobility. Restenosis occurred in six patients who were immediately revised with T-tube stenting. Decanulation was eventually achieved in 57 patients (93.4%). Complications occurred in 25 patients, the most common being subcutaneous emphysema (n=5). One patient died of acute myocardial infarction on the 14th postoperative day.

CONCLUSIONS:

CTR is a relatively safe procedure with a high success rate in primary and revised procedures. A staged procedure should be planned in specific situations, namely, quadriplegics and patients with bilateral impaired vocal cord mobility.

• Authors: Adi Primov-Fever, Yoav P Talmi, Alon Yellin, Michael Wolf
• Journal: The Israel Medical Association journal : IMAJ (Isr Med Assoc J) Vol. 8 Issue 8 Pg. 543-7 (Aug 2006) ISSN: 1565-1088 [Print] Israel
• PMID: 16958244 (Publication Type: Comparative Study, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Airway Obstruction (surgery)
• Anastomosis, Surgical
• Cricoid Cartilage (surgery)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Plastic Surgery Procedures (methods)
• Retrospective Studies
• Trachea (surgery)
• Treatment Outcome