Surveillance endoscopy in pediatric tracheostomy: A systematic review

Area of Science:

• Pediatric Otolaryngology
• Respiratory Medicine
• Surgical Endoscopy

Background:

• Pediatric patients with tracheostomies are at risk for airway complications.
• Surveillance airway endoscopy is a diagnostic tool for monitoring these patients.
• The yield and utility of this procedure require systematic evaluation.

Purpose of the Study:

• To systematically review the literature on the diagnostic yield of surveillance airway endoscopy in pediatric patients with tracheostomies.
• To identify common airway findings, intervention rates, and predictive factors.

Main Methods:

• A systematic literature search was conducted using PRISMA guidelines across MEDLINE/PubMed and Embase.
• Data extraction focused on abnormal airway findings, interventions performed during endoscopy, and predictors of abnormal findings.

Main Results:

• Seven studies were included, with endoscopy timing varying from 1 to 24 months post-tracheostomy.
• Abnormal airway findings ranged from 20% to 87%, with granulomas/granulation tissue being most common, followed by stenosis and suprastomal collapse.
• Interventions were performed in 18%-64% of patients, primarily debridement and dilation; tracheostomy-related symptoms predicted abnormal findings.

Conclusions:

• Pediatric tracheostomy patients undergoing surveillance endoscopy show a high incidence of airway abnormalities and interventions.
• Routine surveillance endoscopy in asymptomatic pediatric tracheostomy patients is not yet recommended pending further research.