Abstract

Onotai LO *, Etawo US

Background: Airway management in the paediatric age group may be challenging to both the anesthetists and otolaryngologists. Clinicians usually consider tracheostomy only in circumstances where no other alternative is available because of its associated complications. Objective: This study was carried out to establish the pattern of paediatric tracheostomies in our setting. It will also highlight the common indications, complications and outcomes of tracheostomized paediatric patients. Lastly, it will obtain baseline data for future studies. Patients and methods: A retrospective case series of all paediatric patients, 5 days old to16 years who had tracheostomies in the department of Ear, Nose and Throat (ENT) surgery of University of Port Harcourt Teaching Hospital (UPTH) and Rex Medical centre (RMC) both in Port Harcourt, Nigeria, from January 2002 to December 2011. Patient records were analyzed for demographic data, indications for tracheostomy, types of tracheostomy, operative technique, complications of tracheostomy and outcome. Results: A total of 152 patients had tracheostomy within the study period. There were 104 males and 48 females with M: F ratio of 2.2:1. The age range was 5 days to 16 years with a mean of 4.64 (SD ± 2.35) years. Age group 3-5 years accounted for majority (n=95, 62.50%) of the cases. Upper airway obstruction was the commonest (n=147, 96.71%) indication for tracheostomy and foreign bodies in the larynx ranked highest (n=125, 82.24%) as an etiological factor of the upper airway obstructions. The commonest post-operative complication was post-decannulation airway obstruction (n=22, 14.47%) and there was no mortality associated with the tracheostomies done in this series. Conclusion: Paediatric tracheostomy is an important procedure that continues to be a standard surgical technique for paediatric airway management in spite of its associated complications. Upper airway obstruction due to laryngeal foreign bodies was the commonest indication in our setting whereas; post-decannulation airway obstruction was the commonest complication in our series.