Posterior cricoid split with costal cartilage augmentation for high subglottic stenosis

Abstract

Stenosis of the upper subglottis presents special problems. Its vicinity to the vocal folds leads to a high incidence of vocal fold fixation, and also precludes surgical treatment by cricotracheal resection and anastomosis To describe the experience with posterior cricoid split and insertion of free costal cartilage graft in the treatment of high subglottic stenosis and posterior commissure glottic stenosis. Tertiary care university hospital. Four cases with Grade III/ IV high subglottic stenosis/ posterior commissure glottic webbing recalcitrant to previous surgical therapy treated with posterior cricoid split and insertion of free costal cartilage graft by a laryngo-fissure approach. Temporary airway stenting for 4 months post surgery with a silicone T-Tube. Successful restoration of the airway and decannulation in all 4 cases. Grade III or IV stenosis of the upper half of the subglottis is successfully treated in a high proportion of patients with posterior cricoid split and augmentation with costal cartilage free graft. © 2008 Association of Otolaryngologists of India.