REVIEW ARTICLE
Tracheostomy-related Tracheal Tears in Pediatrics
Mazyad Alenezi1, *, Ali Alsudays2, Sultan Alanazy3, Eman Almashharawi4, Samir Bawazir4
Article Information
Identifiers and Pagination:
Year: 2022Volume: 16
E-location ID: e187430642209290
Publisher ID: e187430642209290
DOI: 10.2174/18743064-v16-e221014-2022-10
Article History:
Received Date: 6/6/2022Revision Received Date: 6/7/2022
Acceptance Date: 19/8/2022
Electronic publication date: 30/12/2022
Collection year: 2022
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Introduction:
Tracheostomy-related tracheal tear is a serious complication that may follow surgical or percutaneous tracheostomy. Pediatric populations carry a higher risk because of anatomical differences. The aim of this article is to review this condition and to help in its diagnosis and management with the assistance of clinical and radiological findings.
Materials and Methods:
An English literature review was done using the terms pediatric, tracheostomy, tracheal tear and tracheostomy tube.
Result:
Two cases reported in the literature met the criteria to be included in the review.
Discussion:
Tracheostomy-related tracheal tear needs immediate diagnosis as it may lead to life-threatening outcomes, such as pneumothorax, respiratory distress, extensive subcutaneous emphysema and pneumomediastinum. Symptoms and complications of the tear may occur intraoperatively or postoperatively. Gold standard methods for diagnosis include flexible or rigid tracheobronchoscopy, which helps in determining the management plan. The treatment choices for iatrogenic tracheal tears depend on the tear site, size, and extension of the tear and patient’s hemodynamic status. Conservative management is sufficient for stable patients with small tears, whereas surgical management is essential for unstable patients and those with large or complicated tears.
Conclusion:
Tracheostomy-related tracheal tear is a serious rare complication. The pediatric age group carries a higher risk of the condition and its management, either conservative or surgical, depends on airway endoscopy findings and patient’s hemodynamic status.
