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Ear Nose Throat J. 2019 Jul 11:145561319859348. doi: 10.1177/0145561319859348. [Epub ahead of print]

Modified Minerva Cervical Thoracic Orthosis for Postoperative Management of Cricotracheal Resection.

Author information

1
1 Department of Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
2
2 Department of Pediatrics Otolaryngology Head and Neck Surgery, C.S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI, USA.
3
3 Princess Margaret Hospital for Children, Subiaco, Western Australia, Australia.
4
4 St John of God Hospital (Murdoch), Murdoch Drive, Murdoch, Western Australia, Australia.
5
5 School of Surgery, University of Western Australia, Nedlands, Western Australia, Australia.
6
6 Department of Orthotics and Prosthetics, University of Michigan Health System, Ann Arbor, MI, USA.

Abstract

The worst complication of cricotracheal resection (CTR) is anastomotic dehiscence, and to limit it, postoperative management at Michigan Medicine included the use of a modified Minerva cervical-thoracic orthosis (MMCTO). To date, there has been no analysis of the risks and benefits of the brace's use following CTR. We analyze this with our retrospective study. A search with the keywords "cricotracheal resection" and "laryngotracheal reconstruction" was performed in the Electronic Medical Record Search Engine to identify patients retrospectively. The Statistical Package for Social Sciences was used for analysis; t test, χ2, and Fisher exact tests were used to analyze data. Fifteen males and 13 females with a median age of 4 years were identified, and almost 2/3 had a supra- and/or infrahyoid release performed. Postoperatively, 12 had a Grillo stitch and an MMCTO for a mean of 7 days. Most had no complications, but the most common complications were agitation due to brace discomfort and skin irritation. The worst complication was stroke. Our MMCTO's design allowed for better head and neck control with relative comfortability, and most patients had no complications with its short-term use. Our modification may be useful adjunct in the postoperative management.

KEYWORDS:

cricotracheal resection; laryngotracheal; orthosis; postoperative complications; reconstruction; subglottic stenosis

PMID:
31296049
DOI:
10.1177/0145561319859348

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