title: Endoscopic posterior cricoid split with costal cartilage graft: A fifteen-year experience.
abstract: To evaluate outcomes of the endoscopic posterior cricoid split with rib graft (EPCS/RG) procedure in the treatment of subglottic stenosis (SGS), posterior glottic stenosis (PGS), and bilateral vocal fold immobility (BVFI).
  
  
  
  Retrospective chart review.
  
  
  
  Chart review of all patients who underwent EPCS/RG at a single tertiary-care facility between 1999 and 2014. Patients were grouped based on the primary indication for the procedure. Decannulation was the primary endpoint. Secondary endpoints were the number of subsequent airway procedures and length of hospitalization.
  
  
  
  Thirty-three patients were identified; 32 had tracheotomy. Overall decannulation rate was 65.6%. Subgroup analysis demonstrated the following decannulation rates: 53.8% for SGS, 100% for PGS, and 28.6% for BVFI. Fisher exact test found a significant difference in overall decannulation rates between groups (P = 0.002). Operation-specific decannulation rates for patients who never required an open procedure were 23% for SGS, 91.6% for PGS, and 28.6% for BVFI. This difference was also statistically significant (P = 0.001). Multivariate logistic regression analysis found prematurity had a positive correlation with decannulation that approached statistical significance (P < 0.051; odds ratio 6.1; 95% confidence interval 0.99, 37.6). The percentage of patients who underwent repeat airway procedures for the groups was 61.5% for SGS, 16.6 % for PGS, and 14.3% for BVFI. The median length of hospitalization after EPCS/RG was 3 days.
  
  
  
  This represents the largest series of patients who have undergone EPCS/RG and demonstrates that the majority of patients can be decannulated after this procedure. Patients with PGS had the highest operation-specific decannulation rates.
  
  
  
  4. Laryngoscope, 127:252-257, 2017.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle Children's Hospital, Seattle, Washington, U.S.A.|Department of Otolaryngology-Head & Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
authors.forename: John P
authors.initials: JP
authors.lastname: Dahl
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle Children's Hospital, Seattle, Washington, U.S.A.
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Purcell
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle Children's Hospital, Seattle, Washington, U.S.A.
authors.forename: Sanjay R
authors.initials: SR
authors.lastname: Parikh
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, University of Washington, Seattle Children's Hospital, Seattle, Washington, U.S.A.
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Inglis
mesh_terms: D002648:Child; D002675:Child, Preschool; D066186:Costal Cartilage / Q000637:transplantation*; D003413:Cricoid Cartilage / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007829:Laryngostenosis / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D012272:Ribs / Q000637:transplantation*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014826:Vocal Cord Paralysis / Q000601:surgery*
keywords: Endoscopic posterior cricoid split with rib graft; and bilateral vocal fold immobility; posterior glottic stenosis; subglottic stenosis