MANAGEMENT OF PERSISTENT PEDIATRIC TRACHEOSTOMAL FISTULAS

Decannulation of a tracheostomy generally results in spontaneous closu re. Occasionally, epithelialization results in persistence of the fist ula, which may be initially treated by local curettage or cautery. Fai lure of these methods constitutes an indication for surgical closure. Dissection of the entire tracheocutaneous tract permits fistula closur e in juxtaposition to but outside the trachea and prevents any iatroge nic airway narrowing. Twelve patients have been so managed over the la st 10 years, and there have been no immediate or long-term complicatio ns. Copyright (C) 1995 by W.B. Saunders Company