Pediatric tracheotomy: Results of a single center study on 46 patients

Abstract

In this study, we aimed to present our tracheotomy experiences in pediatric patients in our hospital. We reviewed the data by analyzing pediatric tracheotomy retrospectively in terms of indications, follow-up and complications. Forty-six pediatric patients who underwent tracheotomy between 2014 and 2021 were included. The indications were examined under five headings according to the diagnoses that led to the tracheotomy of the patients. These were prolonged intubation, upper airway obstruction, craniofacial anomalies, neuromuscular disorders, and postoperative-traumatic sequelae. Twenty-three (50%) of these patients were girls, and 23 (50%) were boys. The mean age of the patients was 53.8±62.9 months. The youngest patient was a 1-day-old newborn, while the oldest patient was 15 years old. Pediatric tracheotomy was performed in 14 patients for prolonged intubation, 12 patients for craniofacial anomalies, 7 patients for upper airway obstruction, 7 patients for postoperative-traumatic sequelae and 6 patients for neuromuscular disorders. Preoperative or postoperative complications were seen in 10 of the patients. The intubation time of the patients who underwent elective tracheotomy was calculated as 25.7±17.1 days. Of these patients, the shortest duration of intubation was 6 days, and the longest duration was 90 days. The smallest diameter of the tracheostomy cannula inserted in the patients was 2.5 mm, while the largest was 7 mm, and the mean was 4.5 mm. In the follow-ups, it was observed that only 6 of the patients were decannulated, 11 of them died, and the remaining 29 continued their lives with tracheostomy. As a result, although pediatric tracheotomy is rare, it is a life-saving surgical procedure for the appropriate indications and can be successfully performed with manageable complications, contrary to expectations, with the appropriate surgical technique and adequate postoperative care.