[Anteroposterior cricoid split interposition grafting for severe glottic and subglottic stenosis].
OBJECTIVE
To study the effect of anterior and posterior cricoid splitting interposition grafting for severe glottic and subglottic stenosis.


METHODS
This is a retrospective study, from 1991 to 2001 years, 25 patients (male 15, female 10, aged 9 to 46 years) with severe glottic and subglottic stenosis were operated with anterior and posterior cricoid splitting interposition grafting method at Tangdu Hospital. All of 25 patients were tracheostomy dependent before reconstruction. 19 patients had previously undergone 1 to 7 (average 2) surgical procedures. The surgical technique consisted of laryngotracheostomy, cricoid lamina midline vertical incision; rib cartilage graft (17 cases), muscular fasciae, perichondrium or split-thickness skin graft (15 cases), pedicle arytenoid cartilage graft (2 cases) and thyroid cartilage graft (1 case) interposition and silicon T-tube stenting for 3 to 6 months.


RESULTS
Twenty-four patients (96%) were successfully decannulated and got an effective phonation. One patient failed decannulation. The follow-up period ranged from 1 to 10 years. All of the 24 patients had a stable airway and effective phonation.


CONCLUSIONS
The anteroposterior cricoid split interposition graft technique was a safe and effective method for the treatment of severe glottic and subglottic stenosis. Careful split of the cricoid, avoiding injury of esophageal musculature, careful hemostasis, a tight suture graft and using stent were the keys of successful operation.
Chen
Wen-xian
WX
Department of Otorhinolaryngology, Tangdu Hospital, Forth Military Medical University Xi'an 710038, China. tdent@fmmu.edu.cn
Ruan
Yan-yan
YY
Li
Gui-ze
GZ
Cui
Peng-cheng
PC
Sun
Yong-zhu
YZ
Guo
Wan-hong
WH
Gao
Peng-fei
PF
D000293:Adolescent; D000328:Adult; D002648:Child; D003413:Cricoid Cartilage / Q000601:surgery / Q000637:transplantation*; D005260:Female; D005931:Glottis; D006801:Humans; D007829:Laryngostenosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014182:Transplantation, Autologous