Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-27T14:00:02.840Z Has data issue: false hasContentIssue false
  • English
  • Français

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.
Get access Rights & Permissions [Opens in a new window]

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Benjamin, B., Curley, J. W. A. (1990) Infant tracheostomy—endoscopy and decannulation. International Journal of Paediatric Otorhinolaryngology 20: 113–121.CrossRefGoogle ScholarPubMed
Black, R. J., Baldwin, D. L., Johns, A. N. (1984) Tracheostomy ‘decannulation panic’ in children: fact or fiction? Journal of Laryngology and Otology 98: 297–304.CrossRefGoogle ScholarPubMed
Carter, P., Benjamin, B. (1983) Ten-year review of paediatric tracheostomy. Annals of Otology, Rhinology and Laryngologv 92: 398–400.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: 896–901.CrossRefGoogle Scholar
Greenberg, L. M., Davenport, H. T., Shimo, G. (1965) Method for difficlt decannulations in children. Archives of Otolarvngology 81: 72–76.CrossRefGoogle Scholar
Joseph, H. T., Jani, P., Preece, J. M., Bailey, C. M., Evans, J. N. G. (1991) Paediatric tracheostomy: persistent tracheo-cutaneous fistula following decannulation. International Journal of Paediatric. Otorhinolaryngology 22: 231–236.CrossRefGoogle ScholarPubMed
Keams, D. B., Albert, D. M., Choa, D. I., Wickstead, M., Bailey, C. M., Evans, J. N. G. (1990) Functional sessment of the paediatric laryngeal airway. Clinical Otolaryngology 15: 53–58.Google Scholar
Kenna, M. A., Reilly, J. S., Stool, S. E. (1986) Tracheostomy in the pre-term infant. Annals of Otology, Rhinology and Larngology 96: 68–71.CrossRefGoogle Scholar
Line, W. S., Hawkins, D. B., Maclaughlin, E. F., Kahlstrom, E., Ensley, J. L. (1986) Tracheostomy in infants and young children: the changing perspective 1970—1985. Laiyngoscope 96: 510–515.CrossRefGoogle Scholar
Maclachlan, R. F (1969) Decannulation in infancy. Journal of Laryngology and Otology 83: 991–1003.CrossRefGoogle ScholarPubMed
Mallory, G. B., Reilly, J. S., Motoyama, E. K., Mutich, R., Kenna, M. A., Stool, S. E. (1985) Tidal flow measurement in the decision to decannulate the paediatric patient. Annals of Otology, Rhinology and Laryngology 94: 454–457.CrossRefGoogle Scholar
Myers, E., Stool, S., Johnson, J. (1985) Technique of tracheotomy. In Tracheotomy. (Myers, E., Stool, S., Johnson, J., eds.), Churchill Livingstone, New York p 125–146.Google Scholar
Ochi, J. W., Bailey, C. M., Evans, J. N. O. (1992) Paediatric airway reconstruction at Great Ormond Street: a ten-year review, III. Decannulation and suprastomal collapse. Annals of Otology. Rhinology and Laryngology (in press).CrossRefGoogle Scholar
Oliver, P. O., Richardson, J. R., Clubb, R. W., Flake, C. G. (1962) Tracheostomy in children. New England Journal of Medicine 267: 613–637.CrossRefGoogle Scholar
Prescott, C. A. (1992) Peristomal complications of paediatric tracheostomy. International Journal of Paediatric Otorhinolaiyngology 23: 141–149.CrossRefGoogle ScholarPubMed
Reilly, J. S., Myer, C. M. III (1985) ‘How I do it’—Head and Neck and Plastic Surgery. Excision of suprastomal granulation tissue. Laryngoscope 95: 1545–1546.CrossRefGoogle Scholar
Rogers, J. H. (1980) Decannulation by external exploration of the tracheostome in children. Journal of Laiyngology and Otology 94: 563–567.CrossRefGoogle ScholarPubMed
Sasaki, C. T., Gaudet, P. T., Peerless, A. (1978) Tracheostomy decannulation. American Journal of Diseases of Children 132: 266–269.Google ScholarPubMed
Scott, J. R., Kramer, S. S. (1978) The paediatric tracheostomy II—radiographic features of difficult decannulations. American Journal of Roentgenology 130: 893–898.CrossRefGoogle Scholar
Swift, A. C., Rogers, J. H. (1987) The outcome of tracheostomy in children. Journal of Laryngology and Otology 101: 936–939.CrossRefGoogle ScholarPubMed
Tucker, J. A., Silberman, H. D. (1972) Tracheostomy in paediatncs. Annals of Otology, Rhinology and Laryngology 81: 818–824.CrossRefGoogle Scholar
Tucker, J. A., Tucker, G. F (1979) A clinical perspective on the development and anatomical aspects of the infant larynx and trachea. In Laryngotracheal problems in the paediatric patient. (Healy, G. B., McGill, T. J. I., eds.), Charles C. Thomas, Illinois, p 3–8.Google Scholar
Wetmore, R. F., Handler, S. D., Potsic, W. P (1982) Paediatric tracheostomy. Experience during the past decade. Annals of Otology, Rhinology and Laryngology 91: 628–632.CrossRefGoogle ScholarPubMed
Wind, J. (1971) Reflections on difficult decannulation. Archives of Otolaryngology 94: 426–431.CrossRefGoogle ScholarPubMed