Pediatric Custom Tracheostomies: A Ten-Year Experience.

Area of Science:

• Medical Devices
• Otolaryngology
• Pediatric Surgery

Background:

• Tracheostomies are crucial for airway management in pediatric patients.
• Standard tracheostomy tubes may lead to complications like tracheal breakdown and ventilation issues.
• Customized and custom tracheostomies offer tailored solutions for complex cases.

Purpose of the Study:

• To analyze the utilization of customized and custom tracheostomies.
• To identify patient demographics and indications for these specialized devices.
• To evaluate trends in tracheostomy design and patient outcomes.

Main Methods:

• Retrospective review of patients undergoing customized or custom tracheostomy.
• Data collected from January 2011 to July 2021.
• Analysis of indications, design modifications, and survival rates.

Main Results:

• 235 patients included: 220 (93%) customized, 15 (7%) custom.
• Common indications: tracheal/stomal breakdown (33%) and ventilation difficulties (27%).
• Most frequent customizations: shaft length (57%). Custom designs addressed persistent air leaks (9 patients).
• Five-year survival: 75.3% for customized vs. 51.4% for custom tracheostomies.

Conclusions:

• This study presents the first cohorts of pediatric patients with customized and custom tracheostomies.
• Modifications, particularly shaft length and cuff design, can mitigate complications.
• These specialized tracheostomies may improve outcomes in challenging ventilation scenarios.