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Tracheocutaneous Fistula After Pediatric Open Airway Reconstruction
Stephen R Chorney1,2, Joanne Stow3, Luv R Javia3,4
1Department of Otolaryngology - Head & Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
The Annals of Otology, Rhinology, and Laryngology
|January 8, 2021
Summary
Persistent tracheocutaneous fistula (TCF) is common after pediatric airway reconstruction, affecting 85% of children. Smaller tracheostomy tubes and stents may promote spontaneous closure, but surgical intervention is often required.
Area of Science:
- Pediatric Otolaryngology
- Airway Reconstruction
- Tracheostomy Management
Background:
- Tracheocutaneous fistula (TCF) is a frequent complication following pediatric tracheostomy decannulation.
- The persistence of TCF after staged open airway reconstruction is not well-documented.
Purpose of the Study:
- To determine the rate of persistent TCF in children after successful decannulation.
- To identify factors associated with TCF persistence or spontaneous closure.
Main Methods:
- A retrospective case series involving chart review of pediatric patients.
- Patients underwent decannulation after double-stage laryngotracheal reconstruction between 2017 and 2019.
Main Results:
- 84.6% of 26 children experienced persistent TCF post-decannulation.
- Spontaneous closure occurred in 15.4% by one month.
- Larger tracheostomy tube and stent diameters correlated with TCF persistence (P<0.05).
- Surgical closure was successful in 93.8% of cases.
Conclusions:
- Persistent TCF is highly prevalent (85%) after staged pediatric airway reconstruction.
- Spontaneous closure is possible within one month and influenced by device size.
- Families should be informed about TCF frequency and potential need for surgical closure.
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