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Frank R. Miller, MD; Marc E. Guay, MD; Thomas Bauer, MD; Harvey M. Tucker, MD

Arch Otolaryngol Head Neck Surg. 1995;121(7):743-748.

Abstract
Objective
To investigate the short- and long-term complications of pediatric tracheostomy, emphasizing posttracheostomy tracheal stenosis in an animal model.

Design
Twenty-five New Zealand white rabbits were randomly assigned to three groups: flap tracheostomy, traditional vertical tracheostomy, and control. Interactive image analysis was used to compare the tracheal cross-section area and circumference between groups 16 weeks after surgery. The incidence of peristomal infections and accidental decannulations was also compared.

Results
The vertical tracheostomy group had a smaller circumference (P=.01) and smaller cross-sectional area (P=.006) than the control or flap tracheostomy groups. A 30% decrease in tracheal cross-sectional area occurred in the vertical tracheostomy group. The flap tracheostomy group had fewer problems with accidental decannulation and peristomal infection compared with the vertical tracheostomy group.

Conclusions
We found no significant risk of tracheal stenosis or adverse effects on tracheal growth for the flap tracheostomy in a developing animal model. This tracheostomy technique may be useful in the management of pediatric patients who require long-term bypass of the upper airway.

(Arch Otolaryngol Head Neck Surg. 1995;121:743-748)

Author Affiliations
From the Department of Otolaryngology, The Cleveland (Ohio) Clinic Foundation. Dr Miller is now with the Department of Otolaryngology—HNS, Malcom Growe Medical Center, Andrews Air Force Base, Md.

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