Cricoid Augmentation by Costal Cartilage Graft in the Treatment of Complex Crico-Tracheal Stenosis in Adults.

Abstract

We present herein our results of cricoid augmentation with costal cartilage in complex crico-tracheal stenosis in adults. This is a retrospective analysis of a prospectively maintained data of patients who underwent surgery for crico-tracheal stenosis at a tertiary care centre from March 2012 to September 2019. Finding of subglottic stenosis with cricoid narrowing was taken as an indication for cricoid split and costal cartilage graft augmentation. Their demographic and clinical data, pre-operative work up, intra-operative details and post-operative course was recorded. Ten patients underwent cricoid split with costal cartilage graft augmentation and crico-tracheal anastomosis between March 2012 and November 2019. The mean age was 29years (range, 22-58years). There were 6 males (60%) and 4 females (40%). All 10 patients underwent circumferential resection of stenosed tracheal segment, cricoid split, interposition of costal cartilage graft and an anastomosis between augmented cricoid and trachea. Eight patients (80%) anterior cricoid split and 2 (20%) had anterior as well as posterior split. Average resected length of trachea was 2.39 cms. Cricoid split with costal cartilage augmentation is a feasible option to expand cricoid lumen in crico-tracheal stenosis. None except one of our patients required any further intervention in mean follow up of 42months and all are free from primary symptoms. The functional results of the surgery were also excellent in 90% of the patients.