Cricotracheal resection in children 2 years of age and younger

Objectives: We examine the surgical outcomes of cricotracheal resection in children 2 years of age and younger. Methods: We performed a retrospective case study involving a single tertiary care children's hospital. All patients who underwent cricotracheal resection from 1993 through January 2006 were included. Patients 2 years old and younger were compared to patients more than 2 years of age (range, 2 to 44 years). The primary outcomes measured were decannulation and complication rates. We used χ² analyses for categorical variables to detect differences in proportions, Student's t-tests for continuous data, and logistical regression to explore for confounding. Significance was set at α = .05, 2-tailed. Results: Fifteen children 2 years of age or younger were identified. Most patients underwent a single-stage operation (n = 12). The overall decannulation rate was 87% (2 failures). Two patients younger than 2 years had postoperative complications, including 1 patient who developed anastomosis dehiscence. When compared to the patients over 2 years of age, patients younger than 2 were more likely to undergo a single-stage procedure (p < .01). Additionally, the cricotracheal resection was more likely to be their first attempt at airway reconstruction (p = .002). Complication and decannulation rates were similar in both groups. Conclusions: Cricotracheal resection can be performed safely and effectively in children less than 2 years old.