Long-term flap tracheostomy in a pediatric animal model.
OBJECTIVE
To investigate the short- and long-term complications of pediatric tracheostomy, emphasizing posttracheostomy tracheal stenosis in an animal model.


METHODS
Twenty-five New Zealand white rabbits were randomly assigned to three groups: flap tracheostomy, traditional vertical tracheostomy, and control. Interactive image analysis was used to compare the tracheal cross-section area and circumference between groups 16 weeks after surgery. The incidence of peristomal infections and accidental decannulations was also compared.


RESULTS
The vertical tracheostomy group had a smaller circumference (P = .01) and smaller cross-sectional area (P = .006) than the control or flap tracheostomy groups. A 30% decrease in tracheal cross-sectional area occurred in the vertical tracheostomy group. The flap tracheostomy group had fewer problems with accidental decannulation and peristomal infection compared with the vertical tracheostomy group.


CONCLUSIONS
We found no significant risk of tracheal stenosis or adverse effects on tracheal growth for the flap tracheostomy in a developing animal model. This tracheostomy technique may be useful in the management of pediatric patients who require long-term bypass of the upper airway.
Miller
F R
FR
Department of Otolaryngology, Cleveland (Ohio) Clinic Foundation, USA.
Guay
M E
ME
Bauer
T
T
Tucker
H M
HM
D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D004195:Disease Models, Animal; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology; D011292:Premedication; D011817:Rabbits; D011897:Random Allocation; D013524:Surgical Flaps / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D014132:Trachea / Q000473:pathology; D014135:Tracheal Stenosis / Q000209:etiology / Q000473:pathology; D014139:Tracheostomy / Q000009:adverse effects / Q000379:methods*
D000900:Anti-Bacterial Agents