Department of Otolaryngology, Baylor College of Medicine, Houston, TX, USA; Department of Surgery, Texas Children's Hospital, Houston, TX, USA.
Department of Otolaryngology, Baylor College of Medicine, Houston, TX, USA.
Int J Pediatr Otorhinolaryngol. 2022 Feb;153:111012. doi: 10.1016/j.ijporl.2021.111012. Epub 2021 Dec 28.
While the majority of pediatric tracheostomies are performed in the setting of chronic and complex medical comorbidities, perioperative tracheostomies following head and neck tumor ablation are generally short-term. Deliberate planning is required for decannulation in this setting and no published protocols currently exist. Our study outlines a management strategy for short-term tracheostomy in pediatric patients following head and neck surgery.
A retrospective study of pediatric head and neck tumor patients undergoing tracheostomy was performed at a quaternary children's hospital from February 1, 2016 to December 31, 2018. Charts were reviewed for demographics, surgical operation, relevant tracheostomy-related complications, and time to decannulation.
Eleven patients with a mean age of 10.4 years (st.dev. 6.7, range: 0.5-23) underwent tracheostomy during their primary ablative/reconstructive surgery. Trans-tracheal pressure monitoring helped direct the need for tracheostomy downsizing and readiness for capping trials. All patients were decannulated before hospital discharge after a mean of 12.8 days (st.dev. 2.5, range: 9-18) and were discharged after a mean of 14.8 days (st.dev. 2.5, range: 11-20).
Pediatric head and neck surgery patients can be quickly and safely decannulated with an instructive protocol and multidisciplinary care.
虽然大多数儿科气管切开术是在慢性和复杂的合并症的情况下进行的，但头颈部肿瘤消融术后的围手术期气管切开术通常是短期的。在这种情况下，需要进行精心的拔管计划，目前尚无已发表的方案。我们的研究概述了头颈部手术后儿科患者短期气管切开的管理策略。
对 2016 年 2 月 1 日至 2018 年 12 月 31 日在一家四级儿童医院接受气管切开术的儿科头颈部肿瘤患者进行了回顾性研究。对病历进行了回顾，以了解人口统计学资料、手术操作、相关气管切开术相关并发症以及拔管时间。
11 例患者平均年龄为 10.4 岁（标准差 6.7，范围：0.5-23），在原发性消融/重建手术期间进行了气管切开术。经气管内压力监测有助于指导气管切开术缩小和准备试堵管的需要。所有患者在平均 12.8 天（标准差 2.5，范围：9-18）后在出院前拔管，平均在 14.8 天（标准差 2.5，范围：11-20）后出院。
具有指导意义的方案和多学科护理可使头颈部手术的儿科患者快速、安全地拔管。
