Developing a Standard of Care for Pediatric Tracheostomy Decannulation

Objectives:1) Recognize which diagnostic modalities are helpful to facilitate safe decannulation. 2) Provide data-driven conclusions about pediatric tracheostomy management, given the recent American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Consensus Statement on Tracheostomy Management (January 2013), which was based on expert opinion alone. 3) Define a pediatric tracheostomy decannulation protocol that can be extended to a large subset of patients.Methods:Study type: 10-year retrospective review of one surgeon’s pediatric tracheotomy decannulation methods. Inclusion criteria: Patients less than 18 years old. Setting: Tertiary care pediatric hospital. Outcome measurements: Airway endoscopy findings, sleep study results, capping trial tolerance, successful decannulation, and tracheocutaneous fistula repair and management.Results:167 patients underwent tracheotomy during this period, and 52 were decannulated. Of these, 22 had suprastomal granulation tissue removed and 4 patients had tonsil...