Tracheotomy is an important technique in the treatment of recurrent pneumonia among handicapped children. It has long been difficult for children to be free from cannulation, but recent progress of technology made it easier to close the tracheotomy site. If children can be free from a tracheotomy tube, their ADL will greatly improve, and the load on their families will be reduced. In our hospital, we are trying to close the tracheotomy site by one month of hospitalization and gradual downsizing of the tubes. We obtained a good result in cases, whose tracheotomy was fresh, or who received a tracheotomy after trauma, or whose cough reflex was well preserved. However, it is important to stop the procedure once there is any sign of possible danger. It is also important to conduct this procedure when the patient is in the best condition.
