Six infants with upper airway obstruction were discussed. Their disease were severe laryngomalacia, trachea-laryngomalacia, subglottic stenosis of the larynx and choanal atresia associated with Crouzon syndrome. They were treated with long term intratracheal intubation for more than 2 months. Three of them had systematic complications.
We succeeded in decannulation with 3 of these patients after long-term intubation, though the others needed tracheotomies. Their average body weight was about 6000g and the average age was 4 or 5 months, when the decannulation was performed.
The three infants who needed tracheotomies had systematic complications. In particular all of them had the GER (gastro-esophageal reflex).
We concluded that the appropriate time for decannulation and tracheotomy in infants is when they are 5 or 6 months old and their body weight about 6000g.
Unless decannulation is successful, because of the severe upper airway stenosis, a tracheotomy is necessary for such patients.
