Decannulation after cricotracheostomy: a comparison of partial cricoid cartilage resection with conventional tracheostomy

Abstract

Background

Cricotracheostomy, a modified procedure to open the airway with partial cricoid cartilage resection, was recently reported to be useful in selected cases.

Aims/objectives

To examine decannulation outcomes in patients who underwent cricotracheostomy by comparing it with a conventional tracheostomy.

Materials and methods

Data from 127 consecutive adult patients, who underwent either conventional tracheostomy or cricotracheostomy between 2016 and 2019, were collected and analyzed with respect to subsequent decannulation with stoma closure.

Results

Conventional tracheostomy and cricotracheostomy were performed in 94 and 33 patients, respectively. The most frequent reason for choosing cricotracheostomy was a physiological low-lying larynx (n = 12). After excluding 30 patients who were considered ineligible due to their primary disease, subsequent decannulation with stoma closure was achieved in 35 (46%) of 76 cases with conventional tracheostomy and seven (33%) of 21 cases with cricotracheostomy, showing no significant difference (p = .33).

Conclusions/significance

Compared with a conventional tracheostomy, cricotracheostomy had an acceptable decannulation outcome. However, it should be emphasized that an appropriate selection of patients is required on considering the advantages of cricotracheostomy.

Chinese abstract

背景：环气管切开术, 即部分切除环状软骨, 是一种改良的开放气道的手术。据最近报道, 该手术在某些病例中是有用的。

目的：比较环气管切开术与传统气管切开术的拔管效果。

材料和方法：收集并分析2016年至2019年间连续127例接受传统气管切开术或环气管切开术的成人患者的数据, 以及随后拔管并关闭呼吸孔的情况。

结果：传统气管切开94例, 环气管切开33例。选择环气管切开术最常见的原因是生理性低洼喉（n¼12）。排除30例因原发疾病而不合适的患者后, 76例常规气管切开术中35例（46%）和21例环气管切开术中7例（33%）取得拔管并关闭呼吸孔, 显示无显著性差异（p¼.33）。

结论/意义：与传统的气管切开术相比, 环气管切开术具有可接受的拔管结果。然而, 应该强调的是, 考虑到环气管切开术的优点, 需要选择合适的病人。

Keywords:

• Tracheostomy
• cricoid cartilage
• partial resection
• cricotracheostomy
• decannulation

Disclosure statement

No potential conflict of interest was reported by the author(s).