Clinical Study
Retrospective Analysis of Pediatric Tracheostomy
Mehmet Akdag,
1,2
Zeynep Baysal,
3
Ayfer Gozu Pirinccioglu,
4
Aylin Gul,
1
FazJl Emre Ozkurt,
1
and Ismail Topcu
1
1
Department of Otolaryngology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
2
Department of ENT & Head and Neck Surgery, Dicle University Medical College, 21280 Diyarbakir, Turkey
3
Department of Anesthesia, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
4
Department of Pediatric Intensive Care, Faculty of Medicine, Dicle University, Diyarbakir, Turkey
Correspondence should be addressed to Mehmet Akdag; drmehmetakdag@hotmail.com
Received 25 February 2014; Revised 22 May 2014; Accepted 5 June 2014; Published 26 June 2014
Academic Editor: Tino Just
Copyright © 2014 Mehmet Akdag et al. his is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose. his paper reviews analyses for tracheostomy within our patient population over the last 6 years. Methods. We conducted
a retrospective chart review of consecutive patients undergoing tracheostomy at the tertiary Dicle University Medical hospital,
Turkey, from January 2006 to December 2012. Patient age, sex, emergency, planned tracheostomy, indications, complications,
and decannulation time were all assessed. Results. Fity-six (34 male, 22 female) adult Pediatric patients undergoing tracheostomy
between 2006 and 2013 were investigated. he most common indication for tracheostomy was upper airway obstruction (66.7%),
followed by prolonged intubation (33.3%). Mean decannulation times ater tracheostomy ranged between 1 and 131 days, the
diference being statistically signiicant ( = 0.040). here was no signiicant diference in terms of mean age (9.8 ± 6.0; = 0.26).
here was also no statistical diference between emergency and planned tracheotomies ( = 0.606). Conclusion. In our patient
population, there was a signiicant decline in the number of tracheotomies performed for prolonged intubation and an increasing
number of patient tracheostomy for upper airway obstruction. According to the literature, permanent decannulation rates were
slightly higher with an increase in genetic diseases such as neuromuscular disease.
1. Introduction
Tracheotomy is one of the most frequent planned thera-
peutic or emergency surgical procedures in critically ill
patients. Pediatric tracheotomy was irst performed in 1620
[1]. Approximately 200 tracheotomies were performed by
Trousseau due to diphtheria with airway obstruction in 1833
[2].
Upper airway obstruction, prolonged ventilator depen-
dence, and hypotonia secondary to neurological impairment
are some of the most common indications for tracheotomy
in pediatric patients. Tracheotomy is performed by making a
cut in the trachea. he small diameter of the infant larynx
and trachea means that minor changes due to mucosal
edema can quickly lead to severe and even life threatening
narrowing of the airway. he infant larynx is hidden by the
hyoid bone, since it occupies a higher position in the neck
than in adults. he thyroid cartilage has a broad leading
edge. Cricoid cartilage is oten prominent, and palpation
to establish the level of the airway can sometimes be
diicult. hese anatomical characteristics that difer from
those in adults may also make management more problem-
atic.
Although indications concerning timing and complica-
tions of tracheotomy in adults have been well described
and established, these are still controversial in the pediatric
population. Most of these indications and complications, and
also decannulation, may exhibit diferent regional approaches
and demographic features.
he purpose of this study was to present our clinical
experience with the indications, complications, demographic
characteristics, decannulation, and other factors involved in
tracheotomy in children and to discuss this experience in the
light of the relevant literature.
Hindawi Publishing Corporation
Advances in Otolaryngology
Volume 2014, Article ID 848262, 4 pages
http://dx.doi.org/10.1155/2014/848262