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Tracheostomy in neurologically compromised paediatric patients: role of starplasty

Published online by Cambridge University Press:  17 August 2015

A Gupta ,
J Stokken ,
P Krakovitz ,
P Malhotra  and
S Anne
A Gupta
Affiliation:
Department of Otolaryngology, Wayne State University, Cleveland, Ohio, USA
J Stokken
Affiliation:
Department of Pediatric Otolaryngology, Head and Neck Institute, Cleveland Clinic, Ohio, USA
P Krakovitz
Affiliation:
Department of Pediatric Otolaryngology, Head and Neck Institute, Cleveland Clinic, Ohio, USA
P Malhotra
Affiliation:
Department of Otolaryngology, Ohio State University, Columbus, Ohio, USA
S Anne*
Affiliation:
Department of Pediatric Otolaryngology, Head and Neck Institute, Cleveland Clinic, Ohio, USA
*
Address for correspondence: Dr Samantha Anne, Department of Pediatric Otolaryngology, Head and Neck Institute, Cleveland Clinic Foundation, 9500 Euclid Ave / A-71, Cleveland, OH 44195, USA Fax: +01 216 445 9409 E-mail: [email protected]
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Abstract

Objectives:

Starplasty tracheostomy is an alternative to traditional tracheostomy. This paper reviews neurologically compromised paediatric patients with tracheostomies and discusses the role of starplasty tracheostomy.

Method:

A retrospective review was conducted of paediatric patients with a neurological disorder who underwent tracheostomy between 1997 and 2011.

Results:

Forty-eight patients, with an average age of 7.3 years, were identified. The most common indications for tracheostomy were: ventilator dependence (39.6 per cent), an inability to tolerate secretions or recurrent aspiration pneumonia (33.3 per cent), and upper respiratory obstruction or hypotonia (12.5 per cent). The most common underlying neurological diagnosis was cerebral palsy. There were no early complications. Eighteen (43 per cent) of 42 patients with follow up experienced at least 1 delayed complication. Only 12 patients (28.6 per cent) were decannulated.

Conclusion:

Patients with primary neurological diagnoses have low rates of decannulation; starplasty tracheostomy should be considered for these patients. Patients with seizure disorder or acute neurological injury tended to have a higher short-term decannulation rate; traditional tracheostomy is recommended in these patients.

Keywords

PediatricsTracheostomyTracheostomyNervous System DiseasesCentral Nervous System DiseasesNeurologic Manifestations
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 10 , October 2015 , pp. 1009 - 1012
Copyright
Copyright © JLO (1984) Limited 2015 

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Footnotes

Presented as a poster at the American Society of Pediatric Otolaryngology Annual Meeting, 18–22 April 2012, San Diego, California, USA.

References

1Butnaru, CS, Colreavy, MP, Ayari, S, Froehlich, P. Tracheotomy in children: evolution in indications. Int J Pediatr Otorhinolaryngol 2006;70:115–19CrossRefGoogle ScholarPubMed
2Ozmen, S, Ozmen, OA, Unal, OF. Pediatric tracheotomies: a 37-year experience in 282 children. Int J Pediatr Otorhinolaryngol 2009;73:959–61CrossRefGoogle ScholarPubMed
3Koltai, PJ. Starplasty: a new technique of pediatric tracheotomy. Arch Otolaryngol Head Neck Surg 1998;124:1105–11CrossRefGoogle ScholarPubMed
4Solares, CA, Krakovitz, P, Hirose, K, Koltai, PJ. Starplasty: revisiting a pediatric tracheostomy technique. Otolaryngol Head Neck Surg 2004;131:717–22CrossRefGoogle ScholarPubMed
5Carron, JD, Derkay, CS, Strope, GL, Nosonchuk, JE, Darrow, DH. Pediatric tracheotomies: changing indications and outcomes. Laryngoscope 2000;110:1099–104CrossRefGoogle ScholarPubMed
6Sautter, NB, Krakovitz, PR, Solares, CA, Koltai, PJ. Closure of persistent tracheocutaneous fistula following “starplasty” tracheostomy in children. Int J Pediatr Otorhinolaryngol 2006;70:99–105CrossRefGoogle ScholarPubMed
7Tasca, RA, Clarke, RW. Tracheocutaneous fistula following pediatric tracheostomy: a 14-year experience at Alder Hey Children's Hospital. Int J Pediatr Otorhinolaryngol 2010;74:711–12CrossRefGoogle ScholarPubMed
8Yeo, WX, Phua, CQ, Lo, S. Is routine chest X-ray after surgical and percutaneous tracheostomy necessary in adults: a systemic review of the current literature. Clin Otolaryngol 2014;39:79–88CrossRefGoogle ScholarPubMed
9Wetmore, RF, Handler, SD, Potsic, WP. Pediatric tracheostomy. Experience during the past decade. Ann Otol Rhinol Laryngol 1982;91:628–32CrossRefGoogle ScholarPubMed