Management of tracheostoma closure in pediatric patients

Abstract

  We examined the resultant tracheostoma closure of 12 patients whose tracheostomy tubes were removed in our hospital and determined that closure of a tracheostoma was possible. The underlying diseases were neonatal respiratory distress syndrome in six patients (five were low-birth-weight neonates (less than 1,000 g)), congenital subglottic stenosis in one, difficulty in extubation after heart surgery in one, idiopathic interstitial pneumonia in one, traffic trauma-related consciousness disorder in two, and craniosynostosis in one. Because the infantile airway is narrow, the subglottic region was evaluated by bronchoscopy, and, subsequently, tracheostomy tubes were changed to smaller ones. After confirming the absence of respiratory abnormalities, the tracheostomy tube was removed. Bronchoscopy revealed stenosis of the subglottic cavity in seven of the 12 patients. In four patients, surgery for subglottic stenosis was performed. The interval between tracheotomy and removal of a tracheostomy tube was particularly prolonged in patients who underwent surgery involving laryngeal operations.