Simulation of Pediatric Endoscopic Cricoid Reduction and Expansion
Austin J. Scholp MS,
Matthew R. Hoffman MD, PhD,
Alessandro De Alarcon MD, MPH,
Mark E. Gerber MD,
Jack J. Jiang MD, PhD,
James Scott McMurray MD
Affiliations
Austin J. Scholp MS
Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
Matthew R. Hoffman MD, PhD
Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
Alessandro De Alarcon MD, MPH
Department of Otolaryngology–Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio, USA
Mark E. Gerber MD
Division of Otolaryngology–Head and Neck Surgery, Phoenix Children’s Hospital, Phoenix, Arizona, USA
Jack J. Jiang MD, PhD
Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
James Scott McMurray MD
Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
Endoscopic cricoid expansion and reduction are newer approaches to the management of pediatric bilateral vocal fold immobility and postlaryngotracheal reconstruction glottic insufficiency, respectively. These procedures offer a less invasive, endoscopic alternative to procedures that typically required open management with a more prolonged recovery. These technically demanding procedures are currently performed only in select centers, and there is no currently described training model for practicing them. We present a modification to a laryngeal dissection station that allows for simulation of endoscopic cricoid reduction and expansion with excised larynges. The model allows trainees to practice endoscopic posterior cricoid exposure, incision of the cricoid cartilage, placement of a simulated costal cartilage graft for expansion, and endoscopic suturing for reduction. Development of simulators for procedures that are infrequently performed have the potential to help trainees reach surgical competency faster and more safely.
