Management of persistent tracheocutaneous fistula in the pediatric age group

Yoram Stern, David L. Walner, Matthew Cosenza, Robin T. Cotton

Research output: Contribution to journalArticlepeer-review

Abstract

Different surgical methods have been advocated for closure of persistent tracheocutaneous fistula (TCF) in children. The objective of this study was to compare different methods of repair and postoperative care that were used for management of TCF in children. The charts of 98 children with persistent TCF who were surgically managed in our department between January 1990 and April 1997 were reviewed retrospectively. Excision of the fistulous tract and healing by secondary intention was employed in 18 patients. Eighty patients were managed by tract excision followed by primary closure. Sixty-three patients remained intubated for 18 to 24 hours postoperatively, while 17 patients were extubated in the recovery room. One patient had a large tracheal granuloma on follow-up endoscopy. Three patients needed a second procedure. No significant correlation was found between the method of surgical repair or the length of postoperative intubation and outcome. In our experience, TCF repair, either by primary closure or secondary intention, is a relatively safe and effective procedure in the pediatric age group. Preoperative evaluation and possible indications for selecting the method of repair are discussed.

Original languageEnglish
Pages (from-to)880-883
Number of pages4
JournalAnnals of Otology, Rhinology and Laryngology
Volume108
Issue number9 I
DOIs
StatePublished - 1999
Externally publishedYes

Keywords

  • Pediatrics
  • Tracheocutaneous fistula
  • Tracheotomy

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