Tracheostomy decannulation
C. T. Sasaki, P. T. Gaudet and A. Peerless
Tracheostomy in pediatric patients involves major morbidity that is often
reflected in prolonged decannulation difficulty. A review of 123
consecutive pediatric tracheostomies shows that 44 patients experienced
such difficulties. Among those patients suffering decannulation delay,
subglottic stenosis had developed in 39%, tracheal granuloma in 25%, fused
cords in 11%, and temporary laryngeal abductor failure in 25%. Although the
overall incidence of decannulation failure is high, more than 60% of those
patients affected respond to treatment when diagnosis is prompt and
accurate. In this regard, the laryngologist may play a central role in the
management of the pediatric decannulation process.