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October 1997

A Simple Method for Closure of Tracheocutaneous Fistula in Children

Author Affiliations

From the Department of Otolaryngology—Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Md.

Arch Otolaryngol Head Neck Surg. 1997;123(10):1066-1068. doi:10.1001/archotol.1997.01900100040005

Objective:  To review the results of a simple technique of closure of persistent tracheocutaneous fistula (TCF) in children.

Design:  Retrospective case series.

Setting:  Tertiary pediatric otolaryngology referral center.

Patients:  Children (age, < 18 years) who underwent repair of TCF from July 1, 1991, to August 31, 1996.

Interventions:  Surgical closure of persistent TCF using multilayered closure of de-epithelialized local tissue. Tracheal dissection was not performed. A thermal hemostatic scalpel was used in some cases to assist in de-epithelialization and provide hemostasis without electrocautery near the airway.

Main Outcome Measures:  Success of closure and number and types of complications.

Results:  Nine procedures were performed in 8 children. Seven (88%) of 8 primary procedures were successful, but early recurrent TCF developed in 1 patient. Revision surgery using an identical surgical technique, but maintaining endotracheal intubation for 48 hours, was successful in this patient. No complications occurred.

Conclusions:  This procedure is a simple, reliable method for closure of TCF in children.Arch Otolaryngol Head Neck Surg. 1997;123:1066-1068.

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