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Arch Otolaryngol Head Neck Surg. 1998 Oct;124(10):1105-11.

Starplasty: a new technique of pediatric tracheotomy.

Author information

1
Section of Pediatric Otolaryngology, Cleveland Clinic Foundation, Ohio 44195, USA.

Abstract

OBJECTIVE:

To report a new technique of pediatric tracheotomy that reduces the problems of pneumothorax and recannulation after accidental decannulation in a recently performed tracheotomy.

DESIGN:

Retrospective chart review for 1990-1997.

PATIENTS:

Sixty-eight children aged between 2 days and 14 years.

METHOD:

The starplasty procedure is based on the geometry of a 3-dimensional Z-plasty. The technique of the procedure is described and illustrated in detail.

RESULTS:

There were 27 short-term complications, including 4 accidental decannulations. There were no instances of pneumothorax or tracheotomy-related deaths. There were 25 long-term minor complications. There were no instances of tracheotomy-related death, suprastomal collapse, or tracheal stenosis. Thirty-eight children remain tracheotomy tube dependent, 17 underwent decannulation, 7 died of primary disease, and 6 were lost to follow-up. All 17 children who underwent decannulation have a persistent tracheocutaneous fistula.

CONCLUSIONS:

I conclude that starplasty reduces the incidence of major complications and death. Its only drawback seems to be persistent tracheocutaneous fistula.

PMID:
9776188
[Indexed for MEDLINE]

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