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Evaluation of the effects of three different tracheotomy techniques on tracheal complications and decannulation

Ömer Çelikal1, Rıza Önder Günaydın2, Mehmet Umut Akyol2

  • 1Department of Otolaryngology, Bitlis Tatvan State Hospital, Hospital Street, District of Kulluce Village, 13000, Tatvan, Bitlis, Turkey.

Auris, Nasus, Larynx
|December 21, 2021
PubMed

Insights

Pediatric tracheotomy complications were evaluated across three surgical techniques. No significant differences in complication rates were found between the vertical incision traction suture, vertical incision maturation suture, and Björk techniques.

Area of Science:

  • Otorhinolaryngology
  • Pediatric Surgery
  • Surgical Complications

Background:

  • Pediatric tracheotomy carries a higher risk of complications than in adults.
  • Minimizing complications in pediatric tracheotomy is a critical surgical goal.
  • Several surgical techniques exist, but their comparative efficacy needs further investigation.

Purpose of the Study:

  • To compare the incidence of tracheal complications and decannulation rates among three distinct pediatric tracheotomy techniques.
  • To evaluate the safety and effectiveness of vertical incision traction suture (VITS), vertical incision maturation suture (VIMS), and Björk (BT) techniques.

Main Methods:

  • Retrospective analysis of 62 pediatric patients who underwent tracheotomy.
  • Categorization into three groups based on surgical technique: VITS (n=24), VIMS (n=19), and BT (n=19).
  • Postoperative assessment of tracheotomy-related complications and direct laryngoscopy findings.

Main Results:

  • Severe suprastomal pathology rates: VITS 29.2%, VIMS 15.8%, BT 26.3% (p=0.656).
  • Accidental decannulation rates: VITS 20.8%, VIMS 26.3%, BT 10.5% (p=0.442).
  • Life-threatening events until recannulation: VITS 60%, VIMS 20%, BT 0% (p=0.394).
  • Tracheocutaneous fistula rates: VITS 13.3%, VIMS 40%, BT 33.3% (p=0.337).

Conclusions:

  • No statistically significant differences in overall complication rates were observed between the VITS, VIMS, and BT tracheotomy techniques.
  • Stomal complications remain a common issue in young children undergoing tracheotomy.
  • Further research may be needed to identify optimal techniques for specific pediatric populations.
Abstract

Keywords:
ComplicationsPediatricSurgical proceduresTracheal stenosisTracheotomy

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