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Paediatric tracheostomy: an analysis of 40 cases

Published online by Cambridge University Press:  29 June 2007

S. P. Dubey*
Affiliation:
Department of Otolaryngology, Port Moresby General Hospital, Papua New Guinea
J. P. Garap
Affiliation:
Department of Otolaryngology, Port Moresby General Hospital, Papua New Guinea
*
Address for correspondence: Dr S. P. Dubey, Post Box 3265, Boroko, National Capital District, Papua New Guinea. Fax: (675) 3250342

Abstract

Tracheostomy in the paediatric patient has been associated with significant morbidity and mortality compared to that in the adult. A retrospective analysis was made of 40 patients up to the age of 12 years having tracheostomies. Upper airway obstruction made up the commonest (32 patients, or 80 per cent) indication for paediatric tracheostomy in our series where males slightly outnumbered females. The majority (31 patients, or 77.5 per cent) underwent the operation under general anaesthesia with endotracheal intubation. Thirty-four (85 per cent) patients underwent ‘planned’ tracheostomies and six (15 per cent) underwent ‘crash’ procedures. Thirteen (32.5 per cent) patients were under the age of one year when tracheostomies were performed. The maximum duration of tracheostomies was between one week to within a month and after one month to within three months; each containing 11 (27.5 per cent) patients.

Sixty-four different surgical procedures were performed on these patients in which laryngoscopy and bronchoscopy were the commonest procedures. Nine (22.5 per cent) had early post-operative and 14 (35 per cent) had late post-operative complications. Among these 40 children with tracheostomies, one (2.5 per cent) died due to a tracheostomy-related cause and 10 (25 per cent) due to the primary disease process itself. Tracheostomies performed to provide access for general anaesthesia for other surgical procedures were associated with a better prognosis.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1999

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References

Carter, P., Benjamin, B. (1983) Ten year review of pediatric tracheostomy. Annals of Otology, Rhinology and Laryngology 92: 398400.CrossRefGoogle Scholar
Crysdale, W. S., Feldman, R. I., Naito, K. (1988) Tracheostomies: A 10 year experience in 319 children. Annals of Otology, Rhinology and Laryngology 97: 439443.CrossRefGoogle Scholar
Dubey, S. P., Sengupta, S. K., Vele, D. D. (1996) Nasopharyngeal osteosarcoma as second malignant neoplasm in a posttreated unilateral retinoblastome: Report of a case and review of literature. International Journal of Pediatric Otorhinolaryngology 34: 265271.CrossRefGoogle Scholar
Dutton, J. M., Palmer, P. M., McCulloch, T. M., Smith, R. J. H. (1995) Mortality in pediatric patient with tracheostomy. Head and Neck 17: 403408.CrossRefGoogle Scholar
Gianoli, G. J., Miller, R. H., Guarisco, J. L. (1990) Tracheostomy in the first year of life. Annals of Otology, Rhinology and Laryngology 99: 896901.CrossRefGoogle Scholar
Gilmore, B. B. Jr., Mickelson, S. A. (1986) Pediatric tracheostomy: Controversies in management. Otolaryngologic Clinics of North America 19: 141151.Google Scholar
Kenna, M. A., Reily, J. S., Stool, S. E. (1987) Tracheostomy in the preterm infant. Annals of Otology, Rhinology and Laryngology 96: 6871.CrossRefGoogle Scholar
Line, W. S. Jr., Hawkins, D. B., Kahlstrom, E. J., MacLaughlin, E. F., Ensley, J. L. (1986) Tracheostomy in infants and young children: The changing perspective 1970–1985. Laryngoscope 96: 510515.CrossRefGoogle Scholar
Okafor, B. C. (1983) Tracheostomy in the management of pediatric airway problems. Ear, Nose, Throat Journal 62: 5055.Google ScholarPubMed
Soni, N. K., Chatterji, P., Thind, S. S. (1984) Tracheostomy in children. Indian Journal of Pediatrics 51: 4547.CrossRefGoogle ScholarPubMed
Swift, A. C., Rogers, J. H. (1987) The changing indications for tracheostomy in children. Journal of Laryngology and Otology 101: 12581262.CrossRefGoogle Scholar
Wetmore, R. F., Handler, S. D., Potsic, W. P. (1982) Pediatric tracheostomy: Experience during the past decade. Annals of Otology, Rhinology and Laryngology 91: 628632.CrossRefGoogle ScholarPubMed