Endoscopic assesment of airways before tracheostomy decannulation in children

Lidia Zawadzka-Głos, Beata Zając, Anna Gabryszewska, Mieczysław Chmielik

Summary
Twenty-two children underwent successful decannulation in the Department of Paediatric Otolaryngology of the Medical University in Warsaw from 1993 to 2002. An analysis of patients´ medical records was made. All patients had endoscopic examination – laryngoscopy and bronchoscopy,
before any attempt at decannulation. In some cases, in spite of resolution of the primary lesion for which tracheostomy had been carried out, decannulation was unsuccesful. The most frequent causes of decannulation failure were complications of long-term tracheostomy: suprastomal tracheal wall collapse and granulation tissue. Difficult decannulation was also related to functional factors known as "decannulation panic”. On the basis of their own clinical experience the authors suggest a surgical technique and methods of decannulation.

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