International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Dec 1987
Case ReportsAcquired subglottic cysts in premature infants.
Advances in the management of premature infants have resulted in improved survival. However, long-term intubation may produce associated laryngeal complications. We report 12 infants and children who developed subglottic cysts following long-term intubation as newborns. ⋯ An initial attempt of conservative management with endoscopic excision is made. If this fails, an anterior cricoid split may be indicated in cases where the cysts are associated with soft tissue subglottic stenosis. Tracheostomy may be unavoidable in some cases.
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The cricoid split operation is a well established treatment for subglottic stenosis; the success rate for this procedure is approximately 77%. The management of patients who fail this operation has traditionally involved tracheostomy followed by delayed laryngotracheoplasty. We have treated 22 patients using the cricoid split--6 required subsequent tracheostomy. ⋯ In contrast, 3 patients had repeat cricoid split operations instead of tracheostomy. All 3 of these children have had no further problems with their airway. The authors propose that in patients who fail the cricoid split operation one consider repeating the procedure instead of performing a tracheostomy.