Author(s)
Jennifer F. Ha, MBBS FRACS
Timothy Baerg, BS
Megan Christ, BS
Glenn E. Green, MD
Affiliation(s)
University of Michigan Health System
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to demonstrate the understanding of the use of a modified Minerva cervical thoracic orthosis as an adjunct in the postoperative management of children following cricotracheal or tracheal resection. This knowledge will allow them to explain and discuss its use with family, as well as the risks and benefits. Objectives: The most devastating complication of cricotracheal resection (CTR) is anastomotic dehiscence. Postoperative management in our institution 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 aim to analyze this with our retrospective study. Study Design: Retrospective study. Methods: A search with the keywords cricotracheal resection and laryngotracheal reconstruction was performed in Electronic Medical Record Search Engine to identify the patients retrospectively. The statistical package for social sciences was used. Results: There were 18 males and 13 females with a median age of 3.5 years. Almost 2/3 had release performed. Postoperatively, 20 had Grillo stitch and MMCTO for a mean of 7 days. Most (n=20) had no complications. The most common complications were agitation due to the discomfort of the brace and skin irritation or break down. The single most devastating complication was a stroke. Our MMCTO's design allowed for better head and neck control, wide range and ease of adjustability. Majority of the patients had no or minor complications with its short term. Conclusions: Our novel modification of the brace is a useful adjunct in the postoperative management. However, it is important to be aware of these complications in order to prevent them.