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Greg R. Licameli, MD; Bernard R. Marsh, MD; David E. Tunkel, MD

Arch Otolaryngol Head Neck Surg. 1997;123(10):1066-1068.

Abstract
Objective
To review the results of a simple technique of closure of persistent tracheocutaneous fistula (TCF) in children.

Design
Retrospective case series.

Setting
Tertiary pediatric otolaryngology referral center.

Patients
Children (age, < 18 years) who underwent repair of TCF from July 1, 1991, to August 31, 1996.

Interventions
Surgical closure of persistent TCF using multilayered closure of de-epithelialized local tissue. Tracheal dissection was not performed. A thermal hemostatic scalpel was used in some cases to assist in de-epithelialization and provide hemostasis without electrocautery near the airway.

Main Outcome Measures
Success of closure and number and types of complications.

Results
Nine procedures were performed in 8 children. Seven (88%) of 8 primary procedures were successful, but early recurrent TCF developed in 1 patient. Revision surgery using an identical surgical technique, but maintaining endotracheal intubation for 48 hours, was successful in this patient. No complications occurred.

Conclusions
This procedure is a simple, reliable method for closure of TCF in children.

Arch Otolaryngol Head Neck Surg. 1997;123:1066-1068.

Author Affiliations
From the Department of Otolaryngology—Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Md.

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