TRACHEOSTOMY DECANNULATION IN CHILDREN - APPROACHES AND TECHNIQUES

Various approaches and techniques are used in discontinuing tracheosto my in children, The variability in the use of resources is considerabl e. The objective of this study was to assess decannulation in children attended in a university-affiliated children's hospital. A retrospect ive analysis was made of the medical records of patients who had both tracheostomy (n = 177) and decannulation (n = 30) from 1985 to 1994. T racheostomies, placed at a mean age of 38 months, were discontinued (o n the average) 22 months later, Most children underwent airway endosco py in the operating room in preparation for decannulation, Twenty-four children had downsizing, then capping of the tracheostomy as a functi onal trial, Six children underwent staged laryngotracheoplasty before decannulation. TWO children had decannulation as part of a single-stag e laryngotracheoplasty. Attention to at least one comorbid factor (e.g ., pulmonary, neurologic, or cardiac disease) was important in the dec annulation of each patient in this series, The individualization of tr acheostomy decannulation is necessary for children.