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Starplasty: a new technique of pediatric tracheotomy Koltai PJArch Otolaryngol Head Neck Surg 1998[Oct]; 124 (10): 1105-11OBJECTIVE: 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.|Adolescent[MESH]|Anesthesia, General[MESH]|Child[MESH]|Child, Preschool[MESH]|Cutaneous Fistula/epidemiology[MESH]|Female[MESH]|Fistula/epidemiology[MESH]|Humans[MESH]|Infant[MESH]|Infant, Newborn[MESH]|Male[MESH]|Postoperative Complications/epidemiology[MESH]|Retrospective Studies[MESH]|Suture Techniques[MESH]|Tracheal Diseases/epidemiology[MESH]|Tracheotomy/adverse effects/instrumentation/*methods[MESH] |
