Tracheotomy in the preschool population: indications and outcomes.
OBJECTIVE
Although more tracheotomy procedures are performed within the first year of life than in any other age group, preschool-aged children requiring tracheotomy remain understudied. We characterize the indications and outcomes for patients between the ages of 3 and 6 years undergoing tracheotomy.


METHODS
Out of 480 pediatric tracheotomy procedures performed at a tertiary-care hospital between 1988 and 2004, 15 patients underwent primary tracheotomy between 3 and 6 years of age.


RESULTS
Most (60%) procedures were performed for pulmonary toilet. Upper-airway obstruction represented the second most common indication (40%), and trauma necessitated tracheotomy procedures more often than had been predicted (40%). The decannulation rate was 40%; 2 patients died.


CONCLUSIONS
Trauma contributed to both upper-airway obstruction as well as requirements for pulmonary toilet. These procedures performed secondary to trauma will likely continue to increase.


CONCLUSIONS
Tracheotomy procedures in the preschool population remain uncommon; however, nearly half of those studied were performed as a direct result of otherwise preventable trauma.
Department of Otolaryngology, Vanderbilt University, Nashville, TN 37232, USA. lesley.french@vanderbilt.edu
Lesley C
LC
French
Christopher T
CT
Wootten
Robert G
RG
Thomas
Wallace W
WW
Neblett
Jay A
JA
Werkhaven
Shelagh A
SA
Cofer
D000402:Airway Obstruction / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D011183:Postoperative Complications; D012307:Risk Factors; D013396:Suction / Q000379:methods; D013997:Time Factors; D014140:Tracheotomy; D016896:Treatment Outcome