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Surgical decannulation of children with tracheostomy

Published online by Cambridge University Press:  29 June 2007

A. Al-Saati ,
G. A. J. Morrison ,
R. A. Clary  and
C. M. Bailey
A. Al-Saati
Affiliation:
Department of Otolaryngology, The Hospital for Sick Children, Great Ormond Street, London.
G. A. J. Morrison*
Affiliation:
Department of Otolaryngology, The Hospital for Sick Children, Great Ormond Street, London.
R. A. Clary
Affiliation:
Department of Otolaryngology, The Hospital for Sick Children, Great Ormond Street, London.
C. M. Bailey
Affiliation:
Department of Otolaryngology, The Hospital for Sick Children, Great Ormond Street, London.
*
Mr G. A. J. Morrison, 29 Marney Road, London SW11 5EW.
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Abstract

Over a five-year period during which 99 children underwent successful ward decannulation, 14 other children were deemed unsuitable and underwent surgical decannulation. The technique of surgical decannulation involves excision of the tracheostomy tract with any granuloma and splinting of the anterior tracheal wall by the use of an indwelling nasotracheal tube for 48 hours post-operatively. It is indicated in carefully selected patients whose tracheostomies are complicated by large suprastomal granulomas, anterior tracheal wall collapse or previous anterior rib graft collapse into the airway. Nine of the 14 decannulations were successful. Success is dependent upon accurate prior endoscopic assessment and satisfactory previous reconstruction surgery in cases of subglottic stenosis. The five failures (4.42 per cent of all decannulations) represent some of the most demanding airway problems encountered.

Keywords

TracheostomydecannulationChildren
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 107 , Issue 3 , March 1993 , pp. 217 - 221
Copyright
Copyright © JLO (1984) Limited 1993

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