Tracheal A-frame deformity and suprastomal collapse after pediatric tracheostomy.
Laryngoscope Investig Otolaryngol
; 9(1): e1202, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-38362191
ABSTRACT
Objectives:
To determine the incidence of A-frame deformity and suprastomal collapse after pediatric tracheostomy. Studydesign:
Retrospective cohort.Methods:
All 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.Results:
A 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).Conclusions:
Tracheal 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 evidence 3.
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Base de dados:
MEDLINE
Idioma:
En
Revista:
Laryngoscope Investig Otolaryngol
Ano de publicação:
2024
Tipo de documento:
Article