Infant tracheostomy. A new look with a solution to the difficult cannulation problem.

H C Filston; D G Johnson; R S Crumrine

doi:10.1001/archpedi.1978.02120370020005

Home/Archive/PubMed

PubMed · 717331

Infant tracheostomy. A new look with a solution to the difficult cannulation problem.

H C Filston·D G Johnson·R S Crumrine

View original source ↗Export metadata ↓

Abstract

Although most infant airway and ventilatory problems will be best solved by the use of endotracheal tubes, clear-cut indications for tracheostomy exist. Past reticence to use tracheostomy for infants has been due mainly to the fear of decannulation problems. Recognition of obstructive airway lesions, particularly the lumen-narrowing tracheal stomal granuloma, has been facilitated by the routine use of the newer infant bronchoscopes with optical telescopes. Successful decannulation begins with proper tracheostomy technique, and continues through tracheostomy management and a well-conceived decannulation program. Decannulation should include evaluation of the structure and function of the airway endoscopically and it may include translaryngeal endoscopic resection or formal surgical removal of any obstructing lesions. Experienced nursing personnel are essential to the entire program.

Explore related subjects

Airway Obstruction Bronchoscopes Child Child, Preschool Granuloma, Laryngeal Humans Infant Infant, Newborn Infant, Newborn, Diseases Intubation, Intratracheal Tracheal Stenosis Tracheotomy Journal Article

Keep this discovery

Explore connections, maps & timelines

BibTeX RIS

H C Filston, D G Johnson, R S Crumrine. 1978. Infant tracheostomy. A new look with a solution to the difficult cannulation problem.. https://doi.org/10.1001/archpedi.1978.02120370020005

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2008

Thyroid involvement with Langerhans cell histiocytosis in a 3-year-old male.

We report on the thyroid involvement with Langerhans cell histiocytosis (LCH) in a 3-year-old male. The patient presented with goiter and primary hypothyroidism. His goiter caused life-threatening airway obstruction. He developed locally invasive disease 4 years after his response to LCH therapy. LCH should be suspected as a cause of goiter and thyroidectomy is recommended.

Airway Obstruction↗

PubMed2007

Potential mechanisms connecting asthma, esophageal reflux, and obesity/sleep apnea complex--a hypothetical review.

Obstructive sleep apnea (OSA) and asthma are potentially linked at several levels. The pathophysiology of these two conditions seems to overlap significantly, as airway obstruction, inflammation, obesity, and several other factors are implicated in the development of both diseases. Gastroesophageal reflux disease (GERD), cardiovascular complications, obesity itself, and the underlying inflammatory processes are all complex contributory factors that provide hypothetical links. Furthermore, a collateral rise in prevalence of both OSA and asthma has been noticed during the past few years, occurring in association with the emerging epidemic of obesity, a common risk factor for both conditions. OSA and asthma share many other risk factors as well. We propose a hypothetical OSA-asthma relationship that has implications on the diagnosis and management of patients presenting with either condition singly. Clinicians should be aware that OSA might complicate asthma management. Based on this hypothesis, we suggest that the treatment of the individual patient who experiences both asthma and OSA needs to be multidisciplinary and comprehensive. This hypothetical association of asthma and OSA, though described anecdotally, has not been systematically studied. In particular, the influence of continuous positive airway pressure therapy (for sleep apnea) on asthma outcomes (such as quality of life, steroid utilization, emergency room visits) and fatality needs to be studied further.

Airway Obstruction↗

PubMed2007

Managing isolated subglottic juvenile xanthogranuloma without tracheostomy: case report and review of literature.

Juvenile Xanthogranuloma (JXG) is a dendritic cell related histiocytic disorder which usually presents in the first year of life as a solitary cutaneous granuloma. Isolated presentation in the upper airway is very rare but can result in severe respiratory distress, especially in young children. We present the case of a 5-month-old male with an isolated subglottic JXG lesion. Endoscopic excision provided symptomatic relief and avoided the need for tracheostomy. The lesion has completely resolved 17 months later. Surgical excision without tracheostomy was the treatment of choice in two of the four additional cases of upper airway JXG presented in the literature. JXG has an excellent prognosis with spontaneous regression over time. Histology alone is frequently inadequate to differentiate JXG from the more common Langerhans Cell Histiocytosis (LCH), which carries a much less favorable prognosis. The evolving field of immunohistochemistry provides an essential tool to establish the correct diagnosis. The typical phenotype of JXG is Factor XIIIa+/Fascin+/CD68+/CD163+/CD14+/CD1a-/S100-.

Airway Obstruction↗