Tracheostomy decannulation.

Tracheostomy in pediatric patients involves major morbidity that is often reflected in prolonged decannulation difficulty. A review of 123 consecutive pediatric tracheostomies shows that 44 patients experienced such difficulties. Among those patients suffering decannulation delay, subglottic stenosis had developed in 39%, tracheal granuloma in 25%, fused cords in 11%, and temporary laryngeal abductor failure in 25%. Although the overall incidence of decannulation failure is high, more than 60% of those patients affected respond to treatment when diagnosis is prompt and accurate. In this regard, the laryngologist may play a central role in the management of the pediatric decannulation process.