title: Powered debridement of suprastomal granulation tissue to facilitate pediatric tracheotomy decannulation.
abstract: OBJECTIVE
  To compare suprastomal granulation tissue (SSGT) removal using the microdebrider with other common methods of excision.
  
  
  METHODS
  Retrospective review (n=21) of SSGT excision at a tertiary care pediatric hospital (2004-10). Outcome measures included intraoperative blood loss, operative time, decannulation rates, and complications.
  
  
  RESULTS
  10 children underwent excision of SSGT via powered SSGT debridement and 8 were decannulated (80% success rate). Of the other 11 patients who had manually non-powered techniques (kerrison rongeur, laryngeal microinstruments, or optical forceps), 7 were decannulated (63% success rate). Operative time was on average shorter than all other procedures, but not significantly (p=0.101). There was no significant difference in blood loss when powered debridement was compared to other techniques (p=0.872). There were no significant complications encountered in our patients who received SSGT powered debridement.
  
  
  CONCLUSIONS
  Endoscopic powered SSGT debridement is a simple and useful tool in the process of pediatric tracheotomy decannulation with superior decannulation rate, shorter operative time, and comparable blood loss to other techniques.
authors: Dept. of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, NY, United States. Cchen@montefiore.org
authors: Cynthia
authors: C
authors: Chen
authors: John P
authors: JP
authors: Bent
authors: Sanjay R
authors: SR
authors: Parikh
mesh_terms: D000293:Adolescent; D016063:Blood Loss, Surgical; D002648:Child; D002675:Child, Preschool; D003646:Debridement / Q000295:instrumentation / Q000379:methods*; D020878:Device Removal / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006097:Granulation Tissue / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D014139:Tracheostomy