Tracheotomy in children

Introduction Tracheotomy is one of the most urgent procedures in medicine. It is an operative procedure that creates a surgical airway in the cervical trachea. Aim Tracheostomy refers to a surgical incision made into a trachea. Children are often considered “little people”, however, in medical sense, that is not completely true. The aim of our paper is to review the tracheostomy procedure in children. Materials and Methods In this paper, we analysed the tracheostomies in children performed in the Clinical Centre Nis (Serbia) in the five-year period from January 2015 to December 2019 inclusive. At our centre, all tracheostomies were solely performed by otolaryngologists. Results A total of 37 tracheotomies were performed in the studied period. There were 25 (67.6%) boys and 12 girls (32.4%). The main reason for this relatively low tracheostomy count in our study is because our practitioners are usually performing tracheostomies only in children that require urgent care. All chronic or complicated cases, if they are stable enough to transport, are referred to a higher specialised institution in Belgrade, Serbia. The youngest was a newborn, not older than 1 hour, and the oldest was 17 years old. We divided them into groups according to the age. There were 5 (13.5%) neonates, 25 (67.6%) infants, 3 (8.1%) preschoolers, 2 (5.4%) school-aged children, and 2 (5.4%) adolescents. This is in concurrence with other studies, where authors reported that the highest number of tracheostomies (around 65–70%) were performed before 1 year of age. In most cases, indication for tracheostomies were upper airway obstructions (n = 35, 94.6%). Prolonged orotracheal intubation (n = 1, 2.7%), and protective tracheostomy (n = 1, 2.7%) were the causes in the other two cases. Conclusion While researching the literature for this paper we found that there is little standardisation associated with tracheostomy, even though it is a procedure that is performed regularly all over the globe. There is evidence that there is a disparity in opinions not only among the practitioners in different countries, but in individual countries as well. With the increasing number of patients that require tracheostomy, we find that this topic should be addressed more carefully with the attempt to establish the best way of action for this procedure, and with that, lower the complication and mortality rates.