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December 1978

Infant Tracheostomy: A New Look With a Solution to the Difficult Cannulation Problem

Author Affiliations

From the Divisions of Pediatric Surgery (Dr Filston) and Pediatric Anesthesiology (Dr Crumrine), Case Western Reserve University Affiliated Hospitals, Cleveland; the Pediatric Surgical Service, Duke University Medical Center, Durham, NC (Dr Filston); and the Division of Pediatric Surgery, University of Utah Medical Center, Salt Lake City (Dr Johnson).

Am J Dis Child. 1978;132(12):1172-1176. doi:10.1001/archpedi.1978.02120370020005

• Although most infant airway and ventilatory problems will be best solved by the use of endotracheal tubes, clear-cut indications for tracheostomy exist. Past reticence to use tracheostomy for infants has been due mainly to the fear of decannulation problems. Recognition of obstructive airway lesions, particularly the lumen-narrowing tracheal stomal granuloma, has been facilitated by the routine use of the newer infant bronchoscopes with optical telescopes.

Successful decannulation begins with proper tracheostomy technique, and continues through tracheostomy management and a well-conceived decannulation program. Decannulation should include evaluation of the structure and function of the airway endoscopically and it may include translaryngeal endoscopic resection or formal surgical removal of any obstructing lesions. Experienced nursing personnel are essential to the entire program.

(Am J Dis Child 132:1172-1176, 1978)

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