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. 2019 Oct;71(Suppl 1):501-505.
doi: 10.1007/s12070-018-1373-9. Epub 2018 May 3.

Changing Indications for Pediatric Tracheotomy: An Urban Indian Study

Saudamini J Lele  1 , Sharafine Stephen  1 , Eswaran V Raman  1
Affiliations

Changing Indications for Pediatric Tracheotomy: An Urban Indian Study

Saudamini J Lele et al. Indian J Otolaryngol Head Neck Surg. 2019 Oct.

Abstract

To review the changing indications, decannulation rates, complications and mortality in pediatric tracheotomies. Medical records of children who underwent primary or revision tracheotomy from April 2003 to December 2015 were retrospectively analyzed. Patient characteristics including age, sex, preoperative diagnosis and indications for tracheotomy. The complications, mortality and decannulation rates for the tracheotomies were studied. There were 101 patients who underwent tracheotomy over a period of 13 years. Out of these, complete data was available for 99 patients. There were 61 males and 38 females and the age of children who underwent tracheotomy on an average ranged from 2 months to 16 years. The indications were divided into five categories: airway obstruction, cardiopulmonary, craniofacial, neurological, and trauma. Out of the 99 patients, 92 patients underwent an elective tracheotomy while only 7 patients underwent an emergency tracheotomy. Fifty-eight patients could be successfully decannulated. 13 patients in our study died during the course of treatment, however, none of the deaths could be directly attributed to the tracheotomy. Three patients developed peristomal granulations requiring intervention, 1 patient had a severe stomal infection, and one patient had a tracheocutaneous fistula requiring surgical closure. Over the last few decades, widespread use of vaccinations and improved pediatric and neonatal intensive care has revolutionized child healthcare in developing countries like ours. This impact is reflected in our finding that neurological impairment has displaced obstructive airway (of infective etiology) as the most common indication for pediatric tracheotomy in the present era.

Keywords: Changing trends; Indian; Indications; Pediatric; Tracheostomy; Tracheotomy.

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Conflict of interest statement

Conflict of interestAll authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Box plot of age distribution in the tracheotomy indication groups
Fig. 2
Fig. 2
Comparison of the changing indications for tracheotomy between the study by Alladi et al. (1991–2003), and our study (2003–2015)
See this image and copyright information in PMC

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