A Pediatric Case of Crico-Tracheostomy for Upper Airway Stricture Due to Neurofibromatosis Type I

Arashi Kenichiro, Tomisato Syuta, Kono Takeyuki, Ozawa Hiroyuki

doi:10.2468/jbes.75.8

<p>Since crico-tracheostomy was first reported by Kano et al., many case reports of this technique in adult patients have been published. On the other hand, reports of this procedure in pediatric cases are rare. In this report, we describe a pediatric case in which crico-tracheostomy was performed for a giant tumor associated with neurofibromatosis type I, which made a tracheostomy difficult, with a good long-term outcome. The patient was a 9-year-old boy with multiple tumors in the neck and cervical spine due to neurofibromatosis type I. Although surgical fixation of the cervical spine was necessary due to cervical spinal cord compression fracture and atlantoaxial subluxation caused by the tumor, it was decided to prioritize surgical airway management due to narrowing of the pharyngeal cavity and airway stenosis caused by pressure from the neck tumor. The trachea was displaced to the left due to pressure from the tumor, and the posterior bending of the cervical spine also ran closely parallel, making the usual tracheostomy difficult. Therefore, crico-tracheostomy was performed under general anesthesia. It is known that granuloma formation in the trachea is more likely to occur in pediatric patients than in adults during tracheostomy procedures. However, in this case, there was no granuloma formation and the patient was in good condition 14 months after surgery. However, it is necessary to continue monitoring the long-term effects on laryngeal growth and vocal function.</p>

A Pediatric Case of Crico-Tracheostomy for Upper Airway Stricture Due to Neurofibromatosis Type I

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