Evolution of Indications and Results of Pediatric Tracheotomy

Abstract

Aims: Report on our department's experience in performing surgical tracheotomies in children. Material and Methods: This was a cross-sectional, descriptive study conducted in the ENT and Head and Neck Surgery Department of the Hôpital National de Niamey over a period of nine years from January 2016 to December 2024. The study involved children under the age of 15 who had undergone surgical tracheotomy. Results: Thirty-two (32) tracheotomies were performed over nine years. These involved 22 boys (68.75%) and 10 girls (31.25%). The average age of the patients was 8 years, ranging from 10 months to 14 years. Laryngeal papillomatosis was the most common indication, accounting for 31.25% of cases (n=10). Laryngeal foreign bodies and prolonged intubation accounted for 18.75% and 15.62% of indications, respectively. Tracheotomy was elective in 68.75% of cases and urgent in 31.25%. General anaesthesia was used in 90.62% of children. Tracheal opening was performed subisthmically in all cases, and vertical "I" incision was the most common (65.63%). We recorded four (04) intraoperative complications (12.5%), including haemorrhage (two cases) and cardiorespiratory arrest (two cases). The postoperative complications noted were one case of accidental decannulation and one case of mucus plugging. We recorded one death. Conclusion: Paediatric tracheotomy is a rare surgical procedure in our department. Its indications are dominated by upper airway obstruction, particularly laryngeal papillomatosis, and the morbidity and mortality associated with this procedure is low.