Nasser A Fageeh.
Pediatric Tracheostomy: indications and clinical outcome.
Pak J Surg Jan ;31(2):128-32.

Objectives: Th e primary aim of this study is to look at our 10 years experience in pediatric tracheostomy withspecial att ention to its indications, complications and clinical outcome. Design: Retrospective case series. Sett ing: Two tertiary referral hospitals. Methodology: In this study we reviewed the notes of 76 children who underwent tracheostomy between Jan 2004-Dec 2014. Children aged 2 weeks to 12 years were included in the study. Patient’s records were reviewed for age at the time of surgery, sex, indications, complications and successful decannulation. All cases that did not have adequate data or a minimum of two years follow up were excluded from the study. Results: Th e majority of our patients found to be less than one-year-old 41 (53%). Th e most common indication to perform tracheostomy was upper airway obstruction 25 (32%), came next are children having neurogenic related airway problems 20 (26%). Suprastomal granuloma formation 23 (32%) was the highest complication. Decannulation achieved in 38 (50%) of the patients. Th e Highest rate of decannulation was observed in children having prolonged intubation 11 (14%) followed by cranio-facial syndromes 6 (7.8 %) patients. Mortality rate directly related to tracheostomy seen in 1(1.3%) patient. Conclusion: Th e most common indication for tracheostomy in patients was upper airway obstruction and in particular subglott ic stenosis (SGS). Th is is followed by neurological pathology. Th e most common complication was suprastoma granuloma. Th e morbidity associated with tracheostomy in younger children highlights the higher risk compared to adults. Th e mortality rate related directly to tracheostomy was minimal and found to be comparable to what was previously published in the literature.

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