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

TL;DR

This study shows a new endoscopic technique for airway reconstruction is feasible in goats, with potential for human use.

Contribution

A novel endoscopic anterior cricoid rib grafting technique was developed and tested in an animal model.

Findings

The surgery was successful in all three goats with the graft in good position after 7 days.

One goat developed a surgical site infection leading to partial graft resorption.

Abstract

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.

Feasibility pilot animal study.

Animal surgical laboratory at a tertiary hospital and research center.

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.

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.

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.

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