Surveillance endoscopy in pediatric tracheostomy: A systematic review

Bahri, Khaloud Al; Liu, C. Carrie

doi:10.1016/j.ijporl.2020.110533

Cited by 4 publications

(6 citation statements)

References 15 publications

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“…Granulomas are often reported as the most common finding on diagnostic bronchoscopy in patients with tracheostomy tubes. Reported rates in the literature vary between 12% and 59% of tracheostomy patients 4,13,14 . Large granulomas may pose a risk if accidental decannulation were to occur and may prevent capping tolerance or decannulation.…”

Section: Discussionmentioning

confidence: 99%

“…Reported rates in the literature vary between 12% and 59% of tracheostomy patients. 4 , 13 , 14 Large granulomas may pose a risk if accidental decannulation were to occur and may prevent capping tolerance or decannulation. Granulomas are often resected when they are found to be obstructing and various methods for granuloma resection have been described.…”

Section: Discussionmentioning

confidence: 99%

“…Tracheostomy carries significant morbidity and mortality in the pediatric population 1 . During the last several decades, there has been a shift towards tracheostomy for managing chronic respiratory issues 2–4 . As a result, long‐term consequences of tracheostomy placement have become increasingly relevant in the pediatric population.…”

Section: Introductionmentioning

confidence: 99%

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Tracheal A‐frame deformity and suprastomal collapse after pediatric tracheostomy

Suresh,

Dabbous,

Alahari

et al. 2023

Laryngoscope Investig Oto

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ObjectivesTo determine the incidence of A‐frame deformity and suprastomal collapse after pediatric tracheostomy.Study designRetrospective cohort.MethodsAll patients (<18 years) that had a tracheostomy placed at a tertiary institution between 2015 and 2020 were included. Children without a surveillance bronchoscopy at least 6 months after tracheostomy were excluded. Operative reports identified tracheal A‐frame deformity or suprastomal collapse.ResultsA total of 175 children met inclusion with 18% (N = 32) developing A‐frame deformity within a mean of 35.8 months (SD: 19.4) after tracheostomy. For 18 children (18/32, 56%), A‐frame developed within a mean of 11.3 months (SD: 15.7) after decannulation. There were 96 children developing suprastomal collapse (55%) by a mean of 17.7 months (SD: 14.2) after tracheostomy. All suprastomal collapse was identified prior to decannulation. Older age at tracheostomy was associated with a lower likelihood of collapse (OR: 0.92, 95% CI: 0.86–0.99, p = .03). The estimated 5‐year incidence of A‐frame deformity after tracheostomy was 32.8% (95% CI: 23.0–45.3) and the 3‐year incidence after decannulation was 36.1% (95% CI: 24.0–51.8). Highly complex children had an earlier time to A‐frame development (p = .04). At 5 years after tracheostomy, the estimated rate of suprastomal collapse was 73.7% (95% CI: 63.8–82.8).ConclusionsTracheal A‐frame deformity is estimated to occur in 36% of children within 3 years after tracheostomy decannulation. Suprastomal collapse, which approaches 74% at 5 years after tracheostomy, is more common when tracheostomy is placed at a younger age. Surgeons caring for tracheostomy‐dependent children should recognize acquired airway obstruction and appropriately monitor these outcomes.Level of evidence3.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tracheal A‐frame deformity and suprastomal collapse after pediatric tracheostomy

Suresh,

Dabbous,

Alahari

et al. 2023

Laryngoscope Investig Oto

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“…However, routine surveillance with endoscopic airway assessment remains a contentious topic without standardization. In a 2011 study of practice patterns among pediatric otolaryngologists, 38% reported only performing endoscopic airway evaluations before decannulation and 58% reported at least annual endoscopy 8 …”

Section: Discussionmentioning

confidence: 99%

“…In a 2011 study of practice patterns among pediatric otolaryngologists, 38% reported only performing endoscopic airway evaluations before decannulation and 58% reported at least annual endoscopy. 8 Even without endoscopic visualization, regular clinical evaluation by the otolaryngologist can allow for the early detection of abnormalities. This includes assessment for PMV use, a one-way valve that allows air to be inhaled through a tracheostomy tube but only exhaled through the upper airway.…”

Section: Discussionmentioning

confidence: 99%

Pediatric tracheostomy surveillance

Leonard

Mamidi

Mudd

et al. 2021

Pediatric Pulmonology

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We report an unusual case of a 14-month-old ex-28 week, ventilator-dependent male with a history of bronchopulmonary dysplasia and tracheostomy at 2 months of age. Lost to follow-up, at age 9 months, he presented to the emergency department with worsening respiratory distress. The patient was taken to the operating room at which time direct visualization of the airway demonstrated a mass filling the entire glottic inlet without supraglottic or pharyngeal mucosal attachments. The solid, nonvascular, mass appeared to be emanating from a suprastomal site. Excision proved to relieve the airway obstruction and postoperatively the patient has thrived.

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Neonatal Laryngotracheal Anomalies

et al. 2022

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Respiratory distress in the neonate is one of the most common reasons for referral to a tertiary NICU, accounting for more than 20% of admissions. (1) The cause of respiratory distress can range from parenchymal lung disease to anomalies of any portion of the neonatal airway including the nose, pharynx, larynx, trachea, or bronchi. This review will focus on airway anomalies at or immediately below the level of the larynx. Although rare, those with such congenital or acquired laryngotracheal anomalies often require urgent evaluation and surgical intervention. This review describes 1) the pathophysiology associated with congenital and acquired laryngotracheal deformities in the neonate, 2) the clinical presentation and diagnostic evaluation of these anomalies, and 3) the current medical and surgical strategies available in the NICU and after discharge.

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Surveillance endoscopy in pediatric tracheostomy: A systematic review

Cited by 4 publications

References 15 publications

Tracheal A‐frame deformity and suprastomal collapse after pediatric tracheostomy

Tracheal A‐frame deformity and suprastomal collapse after pediatric tracheostomy

Pediatric tracheostomy surveillance

Neonatal Laryngotracheal Anomalies

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