Posterior cricoid plate drill enlargement in idiopathic subglottic stenosis

Idiopathic subglottic stenosis(ISS) is an airway stricture between larynx and trachea, within 1 cm from the vocal cords. Resection-reconstruction presents technical issues because of the need to resect the anterior portion of the cricoid cartilage, but not the posterior plate beyond which the recurrent laryngeal nerves access the vocal cords. The main surgical challenge consists of the minute airway caliber short below the cords, ensuing after the resection. We propose drill posterior cricoid plate molding to obtain antero-posterior and lateral amplification of the laryngo-tracheal anastomosis.