title: Endoscopic posterior cricoid split and rib grafting in 10 children.
abstract: OBJECTIVE
  To report our experience with endoscopic posterior cricoid split and rib graft insertion (EPCS/RG) in children with posterior glottic (PGS) and subglottic stenosis (SGS).
  
  
  METHODS
  Retrospective analysis of case series, with 1 to 2 year follow-up.
  
  
  METHODS
  Tertiary-care pediatric referral center.
  
  
  METHODS
  Ten consecutive patients undergoing EPCS/RG.
  
  
  METHODS
  EPCS/RG is a new procedure that expands the posterior glottic opening by dividing the posterior cricoid lamina endoscopically with a laser and inserting a rib cartilage graft through the laryngoscope.
  
  
  METHODS
  Laryngeal function and hospital stay.
  
  
  RESULTS
  Successful decannulation in two of two patients with PGS and one of five patients with PGS and SGS without further surgery. Of the four not initially decannulated, two were decannulated with adjunctive procedures, and the other two can now tolerate tracheostomy capping for extended periods of time. We achieved improvement in exercise tolerance in three nontracheotomy-dependent patients. For those with established tracheotomies, median hospital stay was 3 days and intensive care unit care was unnecessary. There were no major complications or deterioration of voice or feeding.
  
  
  CONCLUSIONS
  EPCS/RG appears to be safe and effective in the management of PGS in selected pediatric patients. This minimally invasive procedure has advantages over traditional open approaches and destructive endoscopic techniques (cordotomy and arytenoidectomy). The role of EPCS/RG alone in the face of severe grades of SGS appears to be limited.
authors: Department of Otolaryngology/Head and Neck Surgery, University of Washington, Children's Hospital and Regional Medical Center, Seattle 98105, USA. andy.i@seattlechildrens.org
authors: Andrew F
authors: AF
authors: Inglis
authors: Jonathan A
authors: JA
authors: Perkins
authors: Scott C
authors: SC
authors: Manning
authors: Jason
authors: J
authors: Mouzakes
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003413:Cricoid Cartilage / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007223:Infant; D007828:Laryngoscopy / Q000379:methods*; D007829:Laryngostenosis / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D012272:Ribs / Q000637:transplantation*; D012720:Severity of Illness Index; D014826:Vocal Cord Paralysis / Q000209:etiology