title: Endoscopic posterior cricoid split and costal cartilage graft placement in children.
abstract: OBJECTIVE
  To review a multi-institutional experience using endoscopic posterior cricoid split and costal cartilage graft (EPCSCG) placement in the management of pediatric bilateral vocal fold immobility (BVFI), posterior glottic stenosis (PGS), and subglottic stenosis (SGS).
  
  
  METHODS
  Case series with chart review.
  
  
  METHODS
  Tertiary medical centers.
  
  
  METHODS
  Review of all patients treated between 2004 and 2012 with EPCSCG placement in 3 academic and multispecialty group settings. The main outcomes measured include indications, complications, and outcome (need for additional procedures, decannulation rate).
  
  
  RESULTS
  A total of 28 patients underwent EPCSCG. Age range at time of surgery was 1 month to 15 years (mean, 56 months). Overall, 25 of 28 were decannulated or never required tracheostomy, and 24 of 28 had adequate symptom control with mean follow-up of 25 months. Twenty-two patients had resolution of their symptoms without additional procedures. Sixteen patients had SGS in isolation or in combination with cricoarytenoid fixation, glottic stenosis, or vocal fold immobility. Decannulation and/or symptom control was achieved in 14 of 16. Three patients had isolated PGS or cricoarytenoid fixation with all achieving decannulation. Nine patients had isolated BVFI with 7 being able to achieve resolution of their airway symptoms, 5 without additional procedures.
  
  
  CONCLUSIONS
  This descriptive series shows a consistent outcome in more than double the number of cases previously reported in the previously published series. We believe that EPCSCG is an important option to have in the management of pediatric glottis/subglottic stenosis and bilateral vocal fold immobility.
authors: Division of Otolaryngology-Head and Neck Surgery, Northshore University HealthSystem, The University of Chicago Pritzker School of Medicine, Chicago, Illinois 60062, USA. mgerber@northshore.org
authors: Mark E
authors: ME
authors: Gerber
authors: Vikash K
authors: VK
authors: Modi
authors: Robert F
authors: RF
authors: Ward
authors: Verlia M
authors: VM
authors: Gower
authors: James
authors: J
authors: Thomsen
mesh_terms: D000293:Adolescent; D002356:Cartilage / Q000637:transplantation*; D002648:Child; D002675:Child, Preschool; D003413:Cricoid Cartilage / Q000601:surgery*; D004724:Endoscopy; D006801:Humans; D007223:Infant; D007829:Laryngostenosis / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*