The pediatric tracheostomy: III). An appraisal of xerography

Comparatively new in the roentgen evaluation of infants and children, xerography would appear to be ideal for portraying the pediatric airway. Since the radiation dose of xerography is higher than conventional radiography, its image quality is the subject of careful scrutiny in a pediatric setting here described in 23 infants and children with tracheostomies. In this appraisal three pediatric radiologists independently compared each child's xeroradiograph with an accepted control, conventional radiography. The principal conclusion: the xerographic image of the pediatric airway is slightly superior to standard radiography in most studies (40 of 47 paired studies, 85.1%). In all but two comparisons, however, the tracheal morphology is correctly perceived, described, and interpreted in both the standard radiograph and the xeroradiograph. The main role of xerography, then, is its verification of tracheal detail as first depicted by the preliminary radiography. This confirmation is important in this particular pediatric problem, the tracheostomy, which has inherent difficulties in correct roentgen diagnosis.