Anterior cricoid split. Use of hyoid as autologous grafting material.

OBJECTIVE

To examine the use of hyoid as a readily available autologous grafting material for the anterior cricoid split (ACS) procedure.

DESIGN

Prospective analysis of 20 patients undergoing ACS with hyoid interposition grafting for subglottic stenosis over a 3-year period. The patients received at least 1 year of follow-up after surgery.

SETTING

Tertiary care children's hospital.

PATIENTS: Twenty infants (age range, 2-9 months) with endoscopically confirmed acquired and congenital subglottic stenosis. Presenting symptoms included stridor, failure to extubate, and recurrent atypical croup. All 20 children underwent ACS with hyoid interposition grafting.

RESULTS

All 20 patients exhibited improvement in their symptoms of airway obstruction. All 12 patients in whom extubation had previously failed subsequently underwent successful extubation. The 8 patients with symptoms of stridor and atypical croup showed marked improvement in their symptoms. Serial bronchoscopy revealed mucosal healing and incorporation of the hyoid grafts.

CONCLUSION

Hyoid provides a readily available and reliable grafting material for interposition grafting in the ACS procedure for neonates and infants.