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Surgical management of severe suprastomal cricotracheal collapse complicating pediatric tracheostomy

dc.contributor.authorAntón-Pacheco Sánchez, Juan Luis
dc.contributor.authorVillafruela Sanz, Miguel Ángel
dc.contributor.authorLopez, María
dc.contributor.authorGarcía, G.
dc.contributor.authorLuna Paredes, María Carmen
dc.contributor.authorMartínez, A.
dc.date.accessioned2025-01-09T10:08:00Z
dc.date.available2025-01-09T10:08:00Z
dc.date.issued2008-02-01
dc.description.abstractObjective: Suprastomal tracheal collapse may interfere with decannulation in tracheostomized patients. The purposes of the study are to evaluate the role of tracheotomy technique in the ethiology of suprastomal cricotracheal collapse and to report our results in the treatment of this complication. Methods: A retrospective review of children showing severe suprastomal collapse during the period 1990-2007, in a tertiary care children's hospital, was performed. Medical records were assessed for the following data: sex, age, original indication for tracheotomy, surgical technique, endoscopic findings, type of surgical correction, complications, result, and follow-up. Results: Fourteen patients were included in the study, nine girls and five boys. Average age at tracheotomy was 17 months (range: 21 days-8 years), and prolonged ventilatory support was the most common indication (57%). Horizontal H-type tracheotomy was the most frequent technique in patients with suprastomal collapse (n=9), whereas only one patient with a vertical tracheotomy showed this complication (p<0.05). In every case bronchoscopy disclosed a suprastomal tracheal obstruction of at least 50% of the lumen. Mean age at surgical decannulation was 38 months (range: 12-147 months). Two surgical techniques have been used in the treatment of suprastomal collapse: anterior cricotracheal suspension (n=13) and reconstruction with autologous cartilage graft (n=1). All the patients were successfully decannulated although in one case two procedures were required. No recurrence has been observed during long-term follow-up (mean: 8.6 years). Conclusions: Endoscopical examination is essential for the diagnosis of suprastomal collapse and to rule out other causes of decannulation failure. In our experience, the tracheotomy technique seems to have an ethiologic role, and anterior cricotracheal suspension is a simple and effective procedure in the treatment of this tracheostomy related complication.
dc.description.departmentDepto. de Salud Pública y Materno - Infantil
dc.description.facultyFac. de Medicina
dc.description.refereedTRUE
dc.description.statuspub
dc.identifier.citationJ.L. Antón-Pacheco,M. Villafruela,M. López,G. García,C. Luna,A. Martínez. Surgical management of severe suprastomal cricotracheal collapse complicating pediatric tracheostomy. Int J Pediatr Otorhinolaryngol . 2008 ; 72 (2):179-183.
dc.identifier.doi10.1016/j.ijporl.2007.10.001.
dc.identifier.issn0165-5876
dc.identifier.officialurlhttps://doi.org/10.1016/j.ijporl.2007.10.001
dc.identifier.relatedurlhttps://www.sciencedirect.com/science/article/pii/S0165587607004570?via%3Dihub
dc.identifier.urihttps://hdl.handle.net/20.500.14352/113439
dc.issue.number2
dc.journal.titleInternational Journal of Pediatric Otorhinolaryngology
dc.language.isoeng
dc.page.final183
dc.page.initial179
dc.publisherElsevier
dc.rights.accessRightsrestricted access
dc.subject.cdu616-053.2
dc.subject.keywordtracheotomy
dc.subject.keywordsuprastomal collapse
dc.subject.keywordchildren
dc.subject.keywordTracheomalacia
dc.subject.ucmCiencias Biomédicas
dc.subject.unesco32 Ciencias Médicas
dc.titleSurgical management of severe suprastomal cricotracheal collapse complicating pediatric tracheostomy
dc.typejournal article
dc.type.hasVersionVoR
dc.volume.number72
dspace.entity.typePublication
relation.isAuthorOfPublication1c438ed8-f3d9-435f-b185-4af23a35addc
relation.isAuthorOfPublicationdd7e605b-f05a-43bf-9da3-b3395ffb3ee4
relation.isAuthorOfPublication28d8abfa-5a0e-48bc-9c4b-cb08cbb2809f
relation.isAuthorOfPublication.latestForDiscovery1c438ed8-f3d9-435f-b185-4af23a35addc

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