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Tracheostomy in pediatric age - surgical techniques and complications

Dimana Mitsova, Aleksandra Stefanova, Elena Stoyanova, Petya Genova

Abstract

Introduction: With the recent advance in pediatrics the understanding of pediatric tracheostomy has deepened as well. The average number of tracheostomies performed annually on children has risen, which is also related to the development of anesthesiology and intensive pediatric care. Indications for the procedure have become more precise and new techniques are being introduced to diminish the risk of complications. The open tracheostomy technique in pediatric patients differs from the one performed on adults. The aim of the present study is to review the latest surgical techniques for tra­cheostomy in children.

Materials and Methods: The information is collected as a summary of several articles using the key­words: tracheotomy, children, surgeon techniques, obstruction, and starplasty tracheotomy. The worldwide current experience of surgical techniques has been reconfirmed by Otorhinolaryngology clinic “Saint Marina” Hospital Varna.

Results: The main objective of the surgical techniques for tracheostomy in children is to minimize the risk of early post-operative complications. The most common tracheotomy-related cause of mor­tality in children has been reported to be cannula obstruction, followed by accidental decannulation. The most common post-operative complications include pneumomediastinum, pneumothorax, sub­cutaneous emphysema, wound complications and bleeding. The surgical techniques generally applied are Open tracheostomy and percutaneous dilatational tracheostomy. However, over the last decades, a new design for open pediatric tracheostomy has gained superiority, known as Starplasty tracheosto­my, based on the geometry of a 3-dimensional Z-plasty.

Conclusion: The search for a technique for pediatric tracheostomy with lowest possible risk of post­operative complications is still ongoing. In view of the research data gathered it can be concluded that Starplasty tracheostomy, being the most widely applied procedure in recent years, has proved to be a safe and trustworthy alternative to the traditional open techniques. This technique has been recog­nized as the most preferred and recommended type of tracheostomy in early childhood.


Keywords

tracheotomy; children; surgeon techniques; obstruction; star plasty tracheotomy




DOI: http://dx.doi.org/10.14748/ssvs.v2i0.4657

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