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Paediatric tracheostomy: persistent tracheo-cutaneous fistula following decannulation
H T Joseph1, P Jani, J M Preece
1Department of Otolaryngology, Hospital for Sick Children, London, U.K.
Insights
Persistent tracheo-cutaneous fistulas after pediatric tracheostomy for airway obstruction occurred in 43% of patients. Factors like age and duration of the tracheostomy significantly influenced fistula development, with closure procedures described.
Area of Science:
- Pediatric Otolaryngology
- Pediatric Surgery
- Respiratory Medicine
Background:
- Upper airway obstruction is a common indication for tracheostomy in children.
- Tracheostomy in pediatric patients can lead to complications, including tracheo-cutaneous fistulas.
- Understanding risk factors for these fistulas is crucial for patient management.
Purpose of the Study:
- To analyze the incidence and risk factors of persistent tracheo-cutaneous fistulas in children following tracheostomy.
- To describe the surgical technique for tracheo-cutaneous fistula closure.
Main Methods:
- Retrospective analysis of 101 pediatric patients who underwent tracheostomy for upper airway obstruction.
- Data collected included age at tracheostomy, duration of tracheostomy, and development of tracheo-cutaneous fistula.
- Statistical analysis to identify significant relationships between variables and fistula occurrence.
Main Results:
- A persistent tracheo-cutaneous fistula was observed in 43% of the analyzed pediatric cohort.
- Fistula occurrence was significantly associated with younger age at the time of tracheostomy.
- Longer duration of tracheostomy was also a significant predictor of persistent tracheo-cutaneous fistula.
Conclusions:
- Persistent tracheo-cutaneous fistulas are a notable complication in pediatric tracheostomy patients.
- Early decannulation and careful consideration of age and duration may help mitigate fistula risk.
- Surgical closure is an effective option for managing persistent tracheo-cutaneous fistulas.
Abstract:
A retrospective analysis of 101 children with tracheostomies, all performed for upper airway obstruction and who were decannulated in a single department, is reported. Persistent tracheo-cutaneous fistula occurred in 43% of patients and this was significantly related to age at tracheostomy and duration of tracheostomy. The operation of tracheo-cutaneous fistula closure is described.