Surgical management of suprastomal tracheal collapse in children

Publication date: Available online 8 January 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Ali Tawfik, Hisham Atef Ebada, Ahmed Musaad Abd El-Fattah, Elsharawy Kamal

Abstract

Objective

Suprastomal collapse is a complication of pediatric tracheotomy with a potential impact on decannulation success. The aim of this study was to review the experience in the management of pediatric suprastomal collapse in a tertiary-care center, detailing the surgical technique employed.

Methods

This study included 12 tracheotomised children with the diagnosis of suprastomal collapse in the last 5 years. All patients of the study underwent surgical intervention to manage suprastomal collapse to achieve tracheotomy decannulation. The surgical procedure entailed dissection of the pre-existing tracheotomy tract down to the trachea, then excision of the tract flush with the anterior tracheal wall. The tracheal opening was closed transversely with 3-4 interrupted absorbable sutures placed in craniocaudal direction.

Results

At the end of treatment all patients were decannulated successfully. No intraoperative complications were reported. Minor postoperative complications were reported in 3 children in the form of mild surgical emphysema (n=2) and wound infection (n=1). Those patients were successfully managed conservatively.

Conclusion

This technique is a simple and effective procedure enabling immediate decannulation with very low morbidity. In a long term follow up period, no recurrence has been reported and all patients returned to their usual quality of life.

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