Surgery
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Analysis of the case histories of 17 patients who developed subglottic obstruction following cricothyroidotomy shows that all 10 patients with chronic stenosis had acute laryngeal pathology at the time of initial operation. Seven patients were identified as having acute subglottic obstruction with granulation tissue. Although these patients were effectively managed by local means, ineffective management of intratracheal granulation tissue may convert a minor, temporary problem into a serious chronic obstruction. Cricothyroidotomy is appropriately used for prolonged airway access only in patients free of acute laryngeal pathology.