Anterior cricoid split: The chicago experience with an alternative to tracheotomy

Twenty‐six infants and children underwent anterior cricoid split (ACS) in an attempt to avoid tracheotomy. Twenty (77%) were extubated successfully without tracheotomy; six (23%) failed and required tracheotomy. Our experience corroborates that reported in the literature. To date, 106 (77%) of 138 patients who have undergone ACS have been extubated successfully without tracheotomy. These results substantiate the validity of the operation when done for the proper indications. Substantive glottic and tracheal pathology indicate a high likelihood of failure of ACS. It is not clear precisely why the ACS is effective. Subglottic cysts are a factor in some cases. The histopathology of one such case is presented and the implications discussed.