Document Detail

Changing trends in the success rate of anterior cricoid split.
MedLine Citation:
PMID:  17165666     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We determined the historical trends at our institution in the extubation success rate, defined as avoiding tracheostomy, for infants with acquired laryngotracheal stenosis (LTS) who undergo anterior cricoid split (ACS) as primary treatment. METHODS: We performed a retrospective chart review of all neonates with acquired LTS treated with ACS between 1989 and 2005. Successful extubation rates were assessed over the study's time period. Student's t-test was used to compare identified subgroups. RESULTS: Thirty-one neonates (14 male, 17 female) were identified, with an average gestational age of 27.6 weeks. During 1989 to 1995, a successful cumulative extubation rate of 71.4% was achieved in 14 children. By 2005, though, following a further 17 children, the successful cumulative extubation rate had dropped to 54.8%. The extubation rate in the time period 1996 to 2005 specifically was only 41.2%. The factor identified that most significantly correlated with this change was the difference in average duration of preoperative intubation. Relatively higher numbers of significant neurologic, respiratory, and cardiac comorbidities were identified both in the 1996 to 2005 grouping and in the ACS failure grouping. CONCLUSIONS: The success rate of ACS as a means of avoiding neonatal tracheostomy appears to have declined over the past 10 years at our institution. A prolonged period of preoperative intubation, as well as associated increasingly significant comorbidities, may be explanatory for this change. Revising the accepted selection criteria for ACS, or broadening the indications for alternative techniques, may be warranted.
Brian W Rotenberg; Robert G Berkowitz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of otology, rhinology, and laryngology     Volume:  115     ISSN:  0003-4894     ISO Abbreviation:  Ann. Otol. Rhinol. Laryngol.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-12-14     Completed Date:  2007-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0407300     Medline TA:  Ann Otol Rhinol Laryngol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  833-6     Citation Subset:  AIM; IM    
Department of Otolaryngology, Royal Children's Hospital, Melbourne, Australia.
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MeSH Terms
Cricoid Cartilage / surgery*
Follow-Up Studies
Infant, Newborn
Intubation, Intratracheal
Laryngostenosis / complications,  surgery*
Retrospective Studies
Tracheal Stenosis / complications,  surgery*
Treatment Outcome
Ventilator Weaning / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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