Tracheotomia metodą „starplasty” u dzieci, w materiale Kliniki Otolaryngologii Dziecięcej Katedry Otolaryngologii w Poznaniu

Abstract

IntroductionObvious anatomical differences between larynx and trachea of the adult and the child necessitate different surgical techniques. The “starplasty” technique of pediatric tracheotomy was introduced in 1998 as an alternative pediatric tracheotomy technique associated with several advantages such as easy recannulation in case of accidental decannulation, isolation of trachea secretions from the tracheotomy wound and the absence of stenosis and anterior wall collapse. Aim of the studyThe aim of this study was to compare the new technique of tracheotomy with the traditional one in pediatric patients. Material and methods26 “starplasty” tracheotomies were performed in the Pediatric ENT Dept. from 2006–2010. There were two control groups. The first one consisted of 25 patients and their observation period was 3 years. In the second one there were 14 patients and the observation time was 7 years. In both, the tracheotomy was performed with use of traditional technique. ResultsThe comparison of these groups of patients revealed significant differences in long-term complications such as presence of granuloma tissue (0 after “starplasty”, 8% to 14,3% after traditional technique) and suprastomal collapse (0% after “starplasty”, 8% to 78,6% after traditional tracheotomy). Conclusions“Starplasty” is a safe and easy to perform pediatric tracheotomy technique. It decreases the incidence of short and long-term complications. But the persistence of postoperative tracheocutaneous fistula should limit the indications to perform it only in children in whom the tracheotomy will be permanent.