Treatment of the child might include antibiotics, antireflux medications and steroids. These children, and others with slightly more severe cases, may also be managed with a procedure pioneered by Drs. Cotton and Seid in the early 1980s, termed the anterior cricoid split. This procedure has become less widely used recently. Many favor a more definitive initial strategy.
Many factors dictate the appropriate time to perform the procedure.
The procedure is simple. It involves exposure of the anterior trachea, followed by a vertical midline incision through the inferior two-thirds of the thyroid cartilage, the cricoid and the first two tracheal rings. The patient is left intubated for seven to ten days. If this does not result in successful extubation, endoscopic laser surgery, dilatation, repeat anterior cricoid split, tracheotomy and more extensive laryngotracheoplasty are possible next steps in the management of the child. No need for antihypertensives Grade 1 lesions are usually managed with success endoscopically.