Starplasty: Revisiting a pediatric tracheostomy technique

Clementino Arturo Solares, Paul Krakovitz, Keiko Hirose, Peter J. Koltai

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

To determine the efficacy the starplasty pediatric tracheostomy technique in reducing the incidence of major complications and tracheotomy-related death. Retrospective chart analysis of all the cases of starplasty performed at 2 tertiary care centers between 1990 and 2002. There were 94 children in our cohort ranging in age from 2 days to 14 years. Of the patients, 47 (50%) were females and 47 (50%) were males and 60 of the children (64%) were younger than 1 year of age. Forty-one patients (44%) had neurologically related airway problems as their primary indication for tracheostomy, 34 (36%) had upper airway obstruction, and the remainder had pulmonary diseases, prolonged intubation, or metabolic-related airway problems. There were 41 short-term complications including 5 cases of tracheal tube dislodgement. There were no instances of pneumothorax or tracheostomy-related death. There were 26 long-term complications. There were no cases of clinically relevant suprastomal collapse that compromised decannulation and no instances of tracheal stenosis. Twenty-six patients underwent decannulation, all of whom developed a tracheocutaneous fistula (TCF). Two patients had spontaneous closure of the TCF; 9 patients underwent surgical repair of their fistulas, 53 patients remain tracheostomy-dependent, and 8 patients died of their primary disease. The need for pediatric tracheotomy has increased as a consequence of our success in treating chronically ill children. Starplasty reduces the incidence of major complications, including pneumothorax and death from accidental decannulation. Its major drawback is the need for secondary reconstruction of a tracheocutaneous fistula. EBM rating: C.

Original languageEnglish (US)
Pages (from-to)717-722
Number of pages6
JournalOtolaryngology - Head and Neck Surgery
Volume131
Issue number5
DOIs
StatePublished - Nov 1 2004

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Tracheostomy
Pediatrics
Fistula
Tracheotomy
Pneumothorax
Tracheal Stenosis
Incidence
Airway Obstruction
Intubation
Tertiary Care Centers
Lung Diseases
Chronic Disease

ASJC Scopus subject areas

  • Otorhinolaryngology

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Starplasty : Revisiting a pediatric tracheostomy technique. / Solares, Clementino Arturo; Krakovitz, Paul; Hirose, Keiko; Koltai, Peter J.

In: Otolaryngology - Head and Neck Surgery, Vol. 131, No. 5, 01.11.2004, p. 717-722.

Research output: Contribution to journalArticle

Solares, Clementino Arturo ; Krakovitz, Paul ; Hirose, Keiko ; Koltai, Peter J. / Starplasty : Revisiting a pediatric tracheostomy technique. In: Otolaryngology - Head and Neck Surgery. 2004 ; Vol. 131, No. 5. pp. 717-722.
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