title: A simple method for closure of tracheocutaneous fistula in children.
abstract: OBJECTIVE
  To review the results of a simple technique of closure of persistent tracheocutaneous fistula (TCF) in children.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Tertiary pediatric otolaryngology referral center.
  
  
  METHODS
  Children (age, < 18 years) who underwent repair of TCF from July 1, 1991, to August 31, 1996.
  
  
  METHODS
  Surgical closure of persistent TCF using multilayered closure of de-epithelialized local tissue. Tracheal dissection was not performed. A thermal hemostatic scalpel was used in some cases to assist in de-epithelialization and provide hemostasis without electrocautery near the airway.
  
  
  METHODS
  Success of closure and number and types of complications.
  
  
  RESULTS
  Nine procedures were performed in 8 children. Seven (88%) of 8 primary procedures were successful, but early recurrent TCF developed in 1 patient. Revision surgery using an identical surgical technique, but maintaining endotracheal intubation for 48 hours, was successful in this patient. No complications occurred.
  
  
  CONCLUSIONS
  This procedure is a simple, reliable method for closure of TCF in children.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Md, USA.
authors.forename: G R
authors.initials: GR
authors.lastname: Licameli
authors.forename: B R
authors.initials: BR
authors.lastname: Marsh
authors.forename: D E
authors.initials: DE
authors.lastname: Tunkel
mesh_terms: D002648:Child; D002675:Child, Preschool; D017577:Cutaneous Fistula / Q000601:surgery*; D006801:Humans; D016156:Respiratory Tract Fistula / Q000601:surgery*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods; D014133:Tracheal Diseases / Q000601:surgery*; D016896:Treatment Outcome