The global impact of scoliosis on tracheal abnormalities and ventilation needs in pediatric patients with tracheostomy tubes

Abstract

Purpose

To describe the effects of scoliosis severity on the trachea in patients with a tracheostomy tube.

Materials and methods

A retrospective chart review of patients 21 years and younger with a tracheostomy and scoliosis between 2001 and 2019 was conducted at a single tertiary pediatric hospital. Patients with spine curvature from C6 – T3 (tracheal limits) were divided into two groups based on curvatures that were either greater than or equal to 30° (Group A) or less than 30° (Group B).

Results

Among the 59 patients who met the inclusion criteria, median age at tracheostomy tube placement was 1.45 years, median tracheostomy duration was 10.26 years, and 75 % were ventilator dependent. Group A encompassed 22 patients, and Group B included 37 patients. There were no significant differences in the following outcomes between Groups A and B: obstructed carina view (p = 0.095), tracheal irritation (p = 0.270), tracheal curvature (p = 0.113), inadequate tracheostomy tube fit (p = 0.323), tracheomalacia (p = 0.765), custom tracheostomy tube use (p = 0.113), or ventilator dependence (p = 0.109).

Conclusion

Most tracheostomy patients with scoliosis were ventilator dependent. Spine curvatures of 30° or greater from C6 to T3 did not significantly influence view of the carina, tracheal irritation, tracheal curvature, and tracheostomy tube fit. Further work is needed to analyze the effects of scoliosis on tracheal abnormalities with greater power and to determine the best tracheostomy tube fit via in-office tracheoscopy evaluations.