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Challenge for management without tracheostomy tube after laryngo‐tracheal separation in children with neurological disorders
OBJECTIVES: The present study analyzed surgical outcomes of laryngotracheal separation (LTS) in children with neurological disorders. The purpose of this study was to investigate respiratory impairment and severe complications after LTS in children, and identify the possibility of permanent tracheos...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley & Sons, Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035946/ https://www.ncbi.nlm.nih.gov/pubmed/33869766 http://dx.doi.org/10.1002/lio2.534 |
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author | Morimoto, Noriko Maekawa, Takanobu Kubota, Masaya Kitamura, Masayuki Takahashi, Nozomi Kubota, Mitsuru |
author_facet | Morimoto, Noriko Maekawa, Takanobu Kubota, Masaya Kitamura, Masayuki Takahashi, Nozomi Kubota, Mitsuru |
author_sort | Morimoto, Noriko |
collection | PubMed |
description | OBJECTIVES: The present study analyzed surgical outcomes of laryngotracheal separation (LTS) in children with neurological disorders. The purpose of this study was to investigate respiratory impairment and severe complications after LTS in children, and identify the possibility of permanent tracheostomy without a tracheostomy tube as the safest respiratory management method. METHODS: Twenty‐eight patients (male:female = 16:12) with neurological disorders (6 months to 32 years) who underwent LTS between January 2012 and April 2018 were reviewed. Tracheal diameter, Cobb angle, and sternocervical spine distance (SCD) were measured to assess the potential risk and possibility of removing tracheostomy tube management. RESULTS: Tracheostomy tube could be removed shortly after LTS in 57% (16/28). However, nine of these patients developed respiratory problems that required tracheostomy tube placement 2 years after LTS. New requirements for a tracheostomy tube as a stent were strongly correlated with SCD (P < .05, odds ratio > 1) as well as tracheal deformity. CONCLUSIONS: Respiratory management in neurologically impaired children after LTS without a tracheostomy tube is challenging because thoracic deformity during physical growth affects tracheal disfiguration. Thoracic deformities and progression of scoliosis should be considered in respiratory management approaches in children with neurological disorders, and long‐term follow‐up by computed tomography is necessary. LEVEL OF EVIDENCE: IV |
format | Online Article Text |
id | pubmed-8035946 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley & Sons, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-80359462021-04-15 Challenge for management without tracheostomy tube after laryngo‐tracheal separation in children with neurological disorders Morimoto, Noriko Maekawa, Takanobu Kubota, Masaya Kitamura, Masayuki Takahashi, Nozomi Kubota, Mitsuru Laryngoscope Investig Otolaryngol Pediatrics and Development OBJECTIVES: The present study analyzed surgical outcomes of laryngotracheal separation (LTS) in children with neurological disorders. The purpose of this study was to investigate respiratory impairment and severe complications after LTS in children, and identify the possibility of permanent tracheostomy without a tracheostomy tube as the safest respiratory management method. METHODS: Twenty‐eight patients (male:female = 16:12) with neurological disorders (6 months to 32 years) who underwent LTS between January 2012 and April 2018 were reviewed. Tracheal diameter, Cobb angle, and sternocervical spine distance (SCD) were measured to assess the potential risk and possibility of removing tracheostomy tube management. RESULTS: Tracheostomy tube could be removed shortly after LTS in 57% (16/28). However, nine of these patients developed respiratory problems that required tracheostomy tube placement 2 years after LTS. New requirements for a tracheostomy tube as a stent were strongly correlated with SCD (P < .05, odds ratio > 1) as well as tracheal deformity. CONCLUSIONS: Respiratory management in neurologically impaired children after LTS without a tracheostomy tube is challenging because thoracic deformity during physical growth affects tracheal disfiguration. Thoracic deformities and progression of scoliosis should be considered in respiratory management approaches in children with neurological disorders, and long‐term follow‐up by computed tomography is necessary. LEVEL OF EVIDENCE: IV John Wiley & Sons, Inc. 2021-02-06 /pmc/articles/PMC8035946/ /pubmed/33869766 http://dx.doi.org/10.1002/lio2.534 Text en © 2021 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC. on behalf of The Triological Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Pediatrics and Development Morimoto, Noriko Maekawa, Takanobu Kubota, Masaya Kitamura, Masayuki Takahashi, Nozomi Kubota, Mitsuru Challenge for management without tracheostomy tube after laryngo‐tracheal separation in children with neurological disorders |
title | Challenge for management without tracheostomy tube after laryngo‐tracheal separation in children with neurological disorders |
title_full | Challenge for management without tracheostomy tube after laryngo‐tracheal separation in children with neurological disorders |
title_fullStr | Challenge for management without tracheostomy tube after laryngo‐tracheal separation in children with neurological disorders |
title_full_unstemmed | Challenge for management without tracheostomy tube after laryngo‐tracheal separation in children with neurological disorders |
title_short | Challenge for management without tracheostomy tube after laryngo‐tracheal separation in children with neurological disorders |
title_sort | challenge for management without tracheostomy tube after laryngo‐tracheal separation in children with neurological disorders |
topic | Pediatrics and Development |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035946/ https://www.ncbi.nlm.nih.gov/pubmed/33869766 http://dx.doi.org/10.1002/lio2.534 |
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