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Lawrence W. C. Tom, MD; Linda Miller, MSN; Ralph F. Wetmore, MD; Steven D. Handler, MD; William P. Potsic, MD

Arch Otolaryngol Head Neck Surg. 1993;119(3):321-324.

Abstract
• Pediatric tracheotomy is a safe procedure, and the tube can be maintained for a prolonged period. There are, however, few guidelines regarding the endoscopic assessment of the airway following tracheotomy. From January 1988 through December 1989, the Division of Otolaryngology of The Children's Hospital of Philadelphia (Pa) performed tracheotomies on 81 patients. Thirty-two children had direct laryngoscopy and bronchoscopy at the time of the procedure, 1 week later, and at 6-month intervals for a minimum of 18 months. Four children had normal airways while 21 had intraluminal stomal granulomas, 16 had development of subglottic stenosis, nine had collapse of the anterior tracheal wall, and three had development of distal tracheal granulations. Sixteen children had multiple lesions. Anatomic changes occur in the airways of the majority of children with long-term tracheotomies, and endoscopic evaluation is an essential part of their care.

(Arch Otolaryngol Head Neck Surg. 1993;119:321-324)

Author Affiliations
From the Division of Otolaryngology, The Children's Hospital of Philadelphia (Drs Tom, Wetmore, Handler, and Potsic, and Ms Miller), and the Department of Otolaryngology—Head and Neck Surgery, The University of Pennsylvania School of Medicine, Philadelphia (Drs Tom, Wetmore, Handler, and Potsic).

Footnotes
Accepted for publication October 30, 1992.

Read before the Joint Meeting of the American Broncho-Esophagological Association and the American Society of Pediatric Otolaryngology, Palm Desert, Calif, April 14, 1992.

Reprint requests to Division of Otolaryngology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104 (Dr Tom).

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