Paediatric tracheostomy. Fifty-seven operations on fifty-three children

Area of Science:

• Pediatric Surgery
• Otolaryngology
• Respiratory Medicine

Background:

• Tracheostomy was a primary intervention for pediatric airway obstruction between 1964-1985.
• The study reviewed 57 tracheostomies in 53 children under 13.
• Complication rates varied significantly by age group.

Purpose of the Study:

• To analyze the outcomes and evolving indications for pediatric tracheostomy.
• To compare complication rates between different age groups and time periods.
• To assess the impact of nasotracheal intubation on tracheostomy use.

Main Methods:

• Retrospective review of pediatric tracheostomy cases.
• Data collection on patient demographics, surgical procedures, and complications.
• Analysis of complication rates in relation to age and intervention type.

Main Results:

• Overall complication rate was 35%, with higher rates (53%) in children under three.
• No intraoperative complications or procedure-related deaths occurred.
• Nasotracheal intubation, introduced in 1973, reduced the need for tracheostomy, especially for acute infections.

Conclusions:

• Pediatric tracheostomy has a low mortality but significant morbidity, particularly in younger children.
• Nasotracheal intubation is a safer alternative for acute airway obstruction.
• Tracheostomy remains crucial for persistent or complex airway obstruction, congenital anomalies, and trauma.