Powered debridement of suprastomal granulation tissue to facilitate pediatric tracheotomy decannulation.

OBJECTIVE

To compare suprastomal granulation tissue (SSGT) removal using the microdebrider with other common methods of excision.

METHODS

Retrospective review (n=21) of SSGT excision at a tertiary care pediatric hospital (2004-10). Outcome measures included intraoperative blood loss, operative time, decannulation rates, and complications.

RESULTS

10 children underwent excision of SSGT via powered SSGT debridement and 8 were decannulated (80% success rate). Of the other 11 patients who had manually non-powered techniques (kerrison rongeur, laryngeal microinstruments, or optical forceps), 7 were decannulated (63% success rate). Operative time was on average shorter than all other procedures, but not significantly (p=0.101). There was no significant difference in blood loss when powered debridement was compared to other techniques (p=0.872). There were no significant complications encountered in our patients who received SSGT powered debridement.

CONCLUSIONS

Endoscopic powered SSGT debridement is a simple and useful tool in the process of pediatric tracheotomy decannulation with superior decannulation rate, shorter operative time, and comparable blood loss to other techniques.