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The Journal of Thoracic and Cardiovascular Surgery, Vol 70, 806-816, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
FG Pearson, JD Cooper, JM Nelems and AW Van Nostrand
Resections at the cricoid level pose the problems of damage to the
recurrent laryngeal nerve and loss of circumferential cartilaginous
support. Strictures within the cricoid ring have usually been managed with
keels or stents, whereas neoplasms have been managed by laryngectomy. This
paper reports on 6 patients with lesions involving the cricoid who were
successfully treated by segmental tracheal resection and removal of all but
a thin shell of posterior cricoid plate. The distal trachea was anastomosed
at the subglottic level within 1 cm. or less of the vocal cords. Two
patients had traumatic transection at the cricotracheal level with
disruption of cricoid cartilage and avulsion of both recurrent nerves. Of
the other 4 patients with tracheal lesions involving the cricoid, 2 had
postintubation strictures, another had chemical burns, and the fourth had
adenoid cystic carcinoma. Primary healing and good clinical results were
obtained in all 6 patients. In the 4 patients with intact recurrent nerves,
nerve function was preserved. This technique provides a method for
resection and reconstruction in one stage for selected lesions at the
cricoid level.
ARTICLES
Primary tracheal anastomosis after resection of the cricoid cartilage with preservation of recurrent laryngeal nerves
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