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Tracheocutaneous fistula following paediatric tracheostomy--a 14-year experience at Alder Hey Children's Hospital

R A Tasca1, R W Clarke

  • 1Department of Otorhinolaryngology, Head and Neck Surgery, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool L12 2 AP, UK. r.tasca@btinternet.com

International Journal of Pediatric Otorhinolaryngology
|April 17, 2010
PubMed

Insights

Tracheocutaneous fistula closure in children has a low complication rate. Early tracheostomy in infants is linked to higher fistula rates, requiring surgical repair with good outcomes.

Area of Science:

  • Pediatric Otolaryngology
  • Surgical Complications
  • Tracheostomy Management

Background:

  • Tracheocutaneous fistula is a potential complication following tracheostomy in children.
  • Understanding the incidence, management, and outcomes of tracheocutaneous fistula is crucial for pediatric surgical care.

Purpose of the Study:

  • To determine the rate of tracheocutaneous fistula requiring surgical repair in pediatric patients.
  • To evaluate the complications and outcomes associated with surgical closure of tracheocutaneous fistulas.

Main Methods:

  • Retrospective review of children who underwent tracheostomy between 1995 and 2009.
  • Analysis of patients requiring subsequent surgical closure of tracheocutaneous fistula.

Main Results:

  • 11.9% of children (23 out of 193) required surgical closure of tracheocutaneous fistula.
  • Children undergoing tracheostomy before age 1 had higher fistula rates, with repair at a median age of 4 years.
  • Surgical repair had a low rate of minor complications (4%) and no major complications, with good cosmetic results.

Conclusions:

  • The rate of tracheocutaneous fistula in this study is comparable to literature values.
  • Age at tracheostomy and duration of tracheostomy appear significantly related to fistula development.
Abstract

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