Cricotracheal resection in children weighing less than 10 kg.
OBJECTIVE
To review cricotracheal resection (CTR) in children weighing less than 10 kg.


METHODS
Retrospective study of 17 patients (mean follow-up, 23 months) from 3 ear, nose, and throat pediatric centers.


METHODS
Seventeen children (10 boys and 7 girls; mean age, 14.6 months; and mean weight, 7.6 kg) undergoing CTR from June 1995 to March 2003.


METHODS
Decannulation rates and endoscopies.


RESULTS
The cause was congenital subglottic stenosis in 2 children (12%) and acquired subglottic stenosis in 15 (88%). All but 1 had grade 3 or 4 stenosis. The mean hospitalization duration was 34 days. Single-stage CTR was performed in 11 children (65%), with peroperative decannulation in 7. Extubation of these patients occurred between days 3 and 9. Decannulation of the other 6 patients was performed after a median of 15 days. Sixteen (94%) of the 17 children were decannulated. Four patients required additional carbon dioxide laser treatment for subsequent glottic or subglottic edema or granulomas, but no reintubation was necessary. One child could not be decannulated because of bronchopulmonary disease, and subglottic stenosis recurred. Long-term tracheotomy was avoided in all other patients. Another child died of cardiac disease. All other patients remained free of significant subglottic stenosis at follow-up.


CONCLUSIONS
Cricotracheal resection in small children weighing less than 10 kg was a safe and effective procedure for severe subglottic stenosis. To our knowledge, this is the first reported attempt of CTR in this weight category, providing results comparable to those published in older children.
Garabedian
Erea-Noël
EN
Department of Pediatric Ear, Nose, and Throat, Armand-Trousseau Children's Hospital, Paris VI University, Assistance Publique-Hôpitaux de Paris, Paris, France. noel.garabedian@trs.ap-hop-paris.fr
Nicollas
Richard
R
Roger
Gilles
G
Delattre
Jerôme
J
Froehlich
Patrick
P
Triglia
Jean-Michel
JM
D001835:Body Weight; D003413:Cricoid Cartilage / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007829:Laryngostenosis / Q000151:congenital / Q000601:surgery; D008297:Male; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D014132:Trachea / Q000601:surgery*; D016896:Treatment Outcome