A Novel Endoscopic Anterior Cricoid Rib Grafting: A Feasibility Study in An Animal Model

Abstract

Abstract Objective The objective of our study was to document the feasibility of a novel endoscopic anterior cricoid split and rib grafting technique in a goat airway model. Study Design Feasibility pilot animal study. Setting Animal surgical laboratory at a tertiary hospital and research center. Methods Three Ardhi goats were utilized. After harvesting and shaping the rib graft, 2 sutures were inserted transversely into the graft. An endoscopic midline anterior cricoid split was performed and extended down through the first tracheal ring, followed by a balloon dilation of the site. Next, the 2 lower and upper graft suture ends were sequentially passed as endo‐extra laryngeal sutures and tied on the anterior neck skin. Laryngeal stent was utilized in 1 goat following graft placement. Results The surgery was successful in all included animals and bronchoscopy performed 7 days after surgery, revealed that the anterior graft was in good position. One goat developed surgical site infection leading to partial graft resorption. Conclusion This study demonstrated the feasibility of this novel procedure which is potentially useful for patients who are candidates for a single‐stage reconstruction. Future studies should investigate the safety and validity of this technique in a model with subglottic stenosis. Level of Evidence NA

Keywords

• airway stenosis
• endoscopic technique
• laryngotracheal reconstruction
• subglottic stenosis