Comparison of open dilatational tracheostomy with conventional pediatric tracheostomy in a growing animal model.
OBJECTIVE
To compare the tracheal changes after applying a new open dilatational tracheostomy (ODT) technique with those from a conventional open tracheostomy (COT) with vertical cartilage incision in a growing animal model.


METHODS
Prospective, experimental investigation in a rabbit model.


METHODS
Thirteen New Zealand white rabbits as a pediatric model were divided into three groups: six rabbits had COT (n = 6), another six underwent an ODT (n = 6), and one rabbit acted as a control. Each rabbit underwent tracheostomy by assigned procedures on the first day. On day 8, they were decannulated. On day 15, their tracheas were harvested. We examined the gross findings and histologic changes of each tracheal segment at the stomal level. In addition, we analyzed three parameters: the quotient of the stomal and nonstomal segment in sagittal diameter, coronal diameter, and cross-sectional area.


RESULTS
The framework of cartilages at the stomal level were more distorted in the COT group. Histologic examination also showed buckling of the anterior tracheal wall, loss of cartilage, infiltration by many polymorphonuclear neutrophils, and the marked ingrowth of fibrous tissue in the COT group. Sagittal and coronal diameters and cross-sectional areas were significantly affected more severely after a COT than after an ODT.


CONCLUSIONS
Our new modification of percutaneous dilatational tracheostomy, named "open dilatational tracheostomy," was successfully applied to a small, growing animal model and showed more favorable and consistent healing of trachea compared with COT. Therefore, the authors' new tracheostomy procedure could be applied to children who require short-term tracheostomy at any age in clinical settings.
Baek
Chung-Hwan
CH
Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea. chbaek@smc.samsung.co.kr
Chung
Young-Jun
YJ
Jeong
Han-Sin
HS
Kim
Sang-Woo
SW
D000818:Animals; D004106:Dilatation; D004195:Disease Models, Animal; D007817:Laryngeal Cartilages / Q000473:pathology / Q000601:surgery; D011446:Prospective Studies; D011817:Rabbits; D014132:Trachea / Q000473:pathology / Q000601:surgery; D014135:Tracheal Stenosis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D014136:Tracheitis / Q000150:complications / Q000473:pathology / Q000517:prevention & control; D014139:Tracheostomy / Q000379:methods*