Decannulation protocol for short term tracheostomy in pediatric head and neck tumor patients

• DOI: 10.1016/j.ijporl.2021.111012
• Publication Date: 2021-12-28T17:27:47Z
• Authors: Peng You; Amy Dimachkieh; Justin Yu; Edward Buchanan; Christina Rappazzo; Tiffany Raynor; Ellis Arjmand; Joshua Bedwell; Randal S. Weber; Michael E. Kupferman; Daniel C. Chelius
• Keywords: 03 medical and health sciences; Tracheostomy; 0302 clinical medicine; Head and Neck Neoplasms; Humans; Child; Hospitals, Pediatric; Device Removal; Retrospective Studies; 3. Good health

While the majority of pediatric tracheostomies are performed in the setting of chronic and complex medical comorbidities, perioperative tracheostomies following head and neck tumor ablation are generally short-term. Deliberate planning is required for decannulation in this setting and no published protocols currently exist. Our study outlines a management strategy for short-term tracheostomy in pediatric patients following head and neck surgery.A retrospective study of pediatric head and neck tumor patients undergoing tracheostomy was performed at a quaternary children's hospital from February 1, 2016 to December 31, 2018. Charts were reviewed for demographics, surgical operation, relevant tracheostomy-related complications, and time to decannulation.Eleven patients with a mean age of 10.4 years (st.dev. 6.7, range: 0.5-23) underwent tracheostomy during their primary ablative/reconstructive surgery. Trans-tracheal pressure monitoring helped direct the need for tracheostomy downsizing and readiness for capping trials. All patients were decannulated before hospital discharge after a mean of 12.8 days (st.dev. 2.5, range: 9-18) and were discharged after a mean of 14.8 days (st.dev. 2.5, range: 11-20).Pediatric head and neck surgery patients can be quickly and safely decannulated with an instructive protocol and multidisciplinary care.