Changing trends in indications of pediatric tracheotomy: A tertiary care center experience

Abstract

Background: Tracheotomy is one of the oldest procedures in medical science. In children, its role began as an emergency procedure to relieve stridor of infectious origin. There has been a change in the indications of tracheotomy over the past few years due to change in the epidemiology of pediatric diseases and advanced medical facilities. Still, a severe lacuna exists in the literature regarding the timing and indications of pediatric tracheotomy. It is a dilema for an otolaryngologist as to when he is justified in giving a child this added morbidity. Aims: To study the changing indications in a pediatric tracheotomy at a tertiary care center. Materials and Methods: A prospective study of 56 children who underwent tracheotomy was carried out over 4 years period at a tertiary care hospital in Punjab. Results: Out of 56 children studied, 19% of children had a tracheotomy for infectious etiology, 41% had a tracheotomy for prolonged intubation 5.3% for laryngotracheal stenosis, and 16% for head injury. Conclusion: With the development of advanced pediatric anesthesia techniques and vaccinations the role of pediatric tracheotomy is changing from an emergency life savior to a more elective procedure. Globalization with regards to the timing and indications of pediatric tracheotomy is the need of the hour to improve the overall mortality of children from various diseases.