Cricotracheal resection with hilar release for pediatric airway stenosis.

OBJECTIVE To determine the effectiveness of cricotracheal resection and hilar release for high-grade, long-segment airway stenosis. DESIGN We identified 16 patients who underwent cricotracheal resection and hilar release, performed from January 1, 2004, through December 31, 2008, and conducted a retrospective review, emphasizing preoperative findings, operative technique, postoperative course, and results. Complete data sets were available for all patients. SETTING Tertiary care children's hospital. PATIENTS The study population comprised 16 patients younger than 18 years who underwent cricotracheal resection and hilar release performed by a thoracic airway team. All patients had high-grade, long-segment subglottic stenosis or severe, long-segment tracheomalacia. INTERVENTION Cricotracheal resection with hilar release. MAIN OUTCOME MEASURES Decannulation rate and dehiscence rate. RESULTS Of the 16 patients, 15 were successfully decannulated. The one patient who was not decannulated remained ventilator dependent and has regained speech. There were no incidents of anastomotic dehiscence. CONCLUSION Cricotracheal resection with hilar release is a novel and effective way to approach the problem of severe airway stenosis.