Research report
An analysis of the inferior based tracheal flap for pediatric tracheotomy

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Abstract

In the past, various tracheotomy incisions have been used at the Children's Hospital of Michigan with the occurrence of complications related to accidental decannulation and immediate recannulation. Since that time the inferior based tracheal cartilage flap has been used to minimize early complications. A retrospective study of 126 pediatric tracheotomies performed at the Children's Hospital of Michigan from June 1986 to January 1991 was reviewed. Only tracheotomies performed by a staff otolaryngologist utilizing the inferior based tracheal cartilage flaps were reviewed. This study includes patients with a 6 month to 5 year follow up. The early complication rate was 4%, while the late was 50%. Stomal granulation tissue was comparatively increased in this series of patients but did not hinder decannulation. We consider the use of the inferior based tracheal cartilage flap in the pediatric population a safe and effective technique without increasing the morbidity of long-term tracheotomy.

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    although there has been a resurgence of diphtheria noted recently from certain parts of our country [8,13]. There has been various opinions with regard to the type of tracheal incision with proponents for each technique highlighting the advantages and limitations [14–17]. Fry et al. in their animal based model, studied the outcomes of various tracheal incisions and found that the vertical incision was superior to the horizontal H shaped tracheal incisions and inferior based tracheal flap in relations to outcomes -specifically the tracheal stenosis and suprastomal collapse [16].

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Presented at the Nineteenth Annual Conference of The Society for Ear, Nose and Throat Advances in Children, Galveston, Texas, December 6, 1991.

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