Tracheostomy-related Tracheal Tears in Pediatrics

Abstract

Introduction: Tracheostomy related tracheal tear is a serious complication that may follow surgical or percutaneous tracheostomy. Pediatric populations carry higher risk because of the anatomical differences. The aim of this article is to review this condition and to help in their diagnosis and management with assistance of clinical and radiological findings. Methods and Materials: An English literature review was done using the terms pediatric, tracheostomy, tracheal tear and tracheostomy tube. Result: Two cases reported in literature that met criteria. Discussion: It needs immediate diagnosis as 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 will be established by flexible or rigid tracheobronchoscopy which helps in determining management plan. Treatment of iatrogenic tracheal tears choices depends on 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. Pediatric age group carry higher risk and management either conservative or surgical depend on airway endoscopy finding and patient’s hemodynamic status.