Clinical Fellow Cincinnati Children's Hospital Medical Center Cincinnati, Ohio
This surgical video demonstrates an anterior-posterior cricoid split with balloon dilation in an infant with bilateral vocal cord paralysis. The patient is first placed into suspension and the posterior cricoid area is injected with lidocaine with epinephrine. A sickle knife is used to make a vertical mucosal incision over the posterior cricoid while the D-knife is used to make a vertical incision through the posterior cricoid cartilage. The superior and inferior portion of the cricoid cartilage can be split with endoscopic scissors. Once the posterior cricoid cartilage is completely divided, the vocal cord spreaders are adjusted to visualize anterior cricoid. The “spring” of the anterior cricoid is then released by splitting the anterior cricoid cartilage. Endoscopic balloon dilation completes the release and the patient is then intubated post operatively. Bronchoscopy one month post surgery shows well healed anterior and posterior splits.