Indications and outcome of pediatric tracheostomy: results from a Nigerian tertiary hospital

A retrospective chart review of 46 patients aged between 2 months and 15 years who presented to our Otorhinolaryngological facility and had tracheostomy between January 2000 and December 2008.The age range was 2 months to 15 years. There were 29 males and 17 females. Thirty two (69.6%) patients were in the age range 6-10 years. Forty tracheostomies (87%) were performed as emergency while 6 (13%) as elective procedures. The commonest indication for tracheostomy was upper airway obstruction (n = 29, 63%). Transverse skin incision was employed in all the cases. No intra-operative complication was recorded. The post-operative complication rate was 15.2%. The duration of tracheostomy ranged from 5 days to 3 months. All the patients were successfully decannulated. The overall mortality was 8 (17.4%). There was no tracheostomy related mortality.There is no increase in the incidence of tracheostomy in patients under 1 year of age and the commonest indication for the procedure in Nigeria has remained relief of upper airway obstruction. Pediatric tracheostomy is safe when performed in the tertiary hospital setting.Tracheostomy in the pediatric age group is different from that in adults. In children it is a more laborious procedure with difficulties in post-operative management and it is commoner for children to suffer greater morbidity and mortality [1,2].There is however a changing trend in the indications and outcomes in the use of tracheostomy in children for airway management [3-5]. In the past, the commonest indication was acute inflammatory airway obstruction [6] but in recent times, prolonged intubation has become the commonest indication [6,7]. Even the age at which tracheostomy is performed is becoming increasingly younger [8]. These have been attributed to the changes in the epidemiology of infectious diseases and the improvement in the capabilities of medical technology [9].Is there a corresponding change in the indications and outcomes of pediatric tracheostomy in