Does the cricoid resection increase the risk of complications in the surgical treatment of benign laryngotracheal stenoses?

purposeThe most of post-intubation stenoses occurs in the cricotracheal segment and require open surgery. Resection of the cricoid arch is a part of the surgical technique that carries certain difficulties. Resection of the cricoid arch, sometimes also the posterior cricoids plate, is part of a surgical technique that carries potential risks of complications, due to the proximity of the recurrent nerve and the need to preserve the airway lumen, in which the cricoids cartilage plays a central role. Purpose of this study is to evaluate whether resection of the cricoid cartilage is associated with a higher incidence of postoperative complications, increased need for additional interventions, prolonged patient recovery, extended hospitalization, and ultimately, a less favorable outcome in the surgical management of cricotracheal stenosis.

methodsRetrospective analysis of 75 elderly patients with circotracheal stenosis divided in two groups: group I with resection of the cricoid arch, group II with submucosal resection of the stenotic connective tissue and preservation of the cricoid arch.

resultsThere is no difference in the length of the resected segment, 3.54 cm–3.48 cm (p = 0.32). Mobilization of the larynx was performed in 13/23 and 21/52 p = 0.004. Postoperatively, 6/23 and 4/52 had a recurrent nerve lesion, p = 0.02. The most common postoperative complications are granulations at the suture line in 21/75 (28%) patients, 12/23 (52.1%) and 9/52 (17.3%) p = 0.008. One patient died (1.3%). Normal respiratory function, without need for tracheostomy, had 98.6% of patients.

conclusionResection of the cricoid arch carries an increased risk of postoperative complications, most often granulation and recurrent nerve lesions, but they don’t affect the final outcome of treatment.