Tracheocutaneous fistula- A surgical challenge

We are experienced a challenge for the surgeon for tracheocutaneous fistula closure in managing such a complication such as chronic cough, infection and other co-morbidities. The need for a secondary closure is also warranted when the stoma does not close on itself within a specified time.

Faculty Opinions recommendation of Tracheocutaneous fistula closure in the pediatric population: should secondary closure be the standard of care?

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718079333.793491121 ◽

2014 ◽

Author(s):

Nina Shapiro ◽

Victor Duarte

Keyword(s):

Pediatric Population ◽

Standard Of Care ◽

Fistula Closure ◽

Tracheocutaneous Fistula Closure in the Pediatric Population: Should Secondary Closure Be the Standard of Care?

Otolaryngology ◽

10.1177/0194599813495815a170 ◽

2013 ◽

Vol 149 (2_suppl) ◽

pp. P90-P90

Author(s):

Alexander J. Osborn ◽

Michael J. Rutter ◽

Catherine K. Hart ◽

Alessandro de Alarcon ◽

Robin T. Cotton

Keyword(s):

Pediatric Population ◽

Standard Of Care ◽

Fistula Closure ◽

Primary versus modified secondary closure techniques for persistent tracheocutaneous fistula in pediatric patients

Pediatric Surgery International ◽

10.1007/s00383-021-04967-2 ◽

2021 ◽

Author(s):

Sung Joon Park ◽

Sun A. Han ◽

Tack-Kyun Kwon ◽

Myung-Whun Sung ◽

Seong Keun Kwon

Keyword(s):

Pediatric Patients ◽

Primary versus secondary closure of tracheocutaneous fistula in pediatric patients

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2021.103213 ◽

2021 ◽

pp. 103213

Author(s):

Christopher H. Azbell ◽

Anna Bakeman ◽

Jennifer L. McCoy ◽

Allison B.J. Tobey

Keyword(s):

Pediatric Patients ◽

Primary tracheocutaneous fistula closure with immediate transition to nocturnal noninvasive positive pressure ventilation in two children with Congenital Central Hypoventilation Syndrome

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2020.110019 ◽

2020 ◽

Vol 134 ◽

pp. 110019

Author(s):

Samantha L. Kallenbach ◽

Mana Espahbodi ◽

Louella B. Amos ◽

David J. Beste ◽

Robert H. Chun

Keyword(s):

Positive Pressure Ventilation ◽

Noninvasive Positive Pressure Ventilation ◽

Positive Pressure ◽

Congenital Central Hypoventilation Syndrome ◽

Fistula Closure ◽

Central Hypoventilation ◽

Hypoventilation Syndrome ◽

Immediate Transition

Delayed complication of tracheocutaneous fistula closure with severe compromising subcutaneous emphysema

BMJ Case Reports ◽

10.1136/bcr-2019-229526 ◽

2019 ◽

Vol 12 (6) ◽

pp. e229526 ◽

Cited By ~ 1

Author(s):

Robert J Lewis ◽

Ari G Mandler ◽

Geovanny Perez ◽

Pamela A Mudd

Keyword(s):

Subcutaneous Emphysema ◽

Complete Resolution ◽

Lessons Learned ◽

Fistula Closure ◽

Significant Complication ◽

Secondary Intention ◽

Delayed Complication ◽

One Year

We report a significant complication after tracheocutaneous fistula (TCF) excision with closure by secondary intention in a 4-year-old boy who had been tracheostomy dependent since infancy. He had a persistent 3 mm TCF one year after decannulation. On postoperative day 2 the patient developed profound subcutaneous emphysema and pneumomediastinum. He was extubated after 2 days and discharged from the hospital on postoperative day 7. At follow up he had complete resolution of subcutaneous emphysema and complete closure of the TCF. The main methods of TCF closure and management of subcutaneous emphysema are discussed along with the lessons learned from this case.

Pediatric tracheocutaneous fistula closure following tracheostomy decannulation

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2019.07.001 ◽

2019 ◽

Vol 125 ◽

pp. 122-127 ◽

Cited By ~ 3

Author(s):

Benjamin L. Wisniewski ◽

Emily L. Jensen ◽

Jeremy D. Prager ◽

Todd M. Wine ◽

Christopher D. Baker

Keyword(s):

Fistula Closure ◽

Tracheocutaneous Fistula

A Novel Approach to Tracheocutaneous Fistula Closure

Otolaryngology ◽

10.1177/0194599811415823a181 ◽

2011 ◽

Vol 145 (2_suppl) ◽

pp. P190-P190

Author(s):

Allison Taraska ◽

Edward Weisberger ◽

Jonathan Y. Ting ◽

Mark Royer ◽

Michael Moore

Keyword(s):

Fistula Closure ◽

Novel Approach ◽

Tracheocutaneous Fistula

Tracheocutaneous Fistula Closure: Comparison of Rhomboid Flap Repair with Z Plasty Repair in a Case Series of 40 Patients

Aesthetic Plastic Surgery ◽

10.1007/s00266-016-0708-8 ◽

2016 ◽

Vol 40 (6) ◽

pp. 908-913 ◽

Cited By ~ 5

Author(s):

Sharad Hernot ◽

Raman Wadhera ◽

Madhuri Kaintura ◽

Sandeep Bhukar ◽

Dheeraj Shashikumar Pillai ◽

...

Keyword(s):

Case Series ◽

Fistula Closure ◽

Flap Repair ◽

Rhomboid Flap

Surgical Management of Tracheocutaneous Fistula

Ear Nose & Throat Journal ◽

10.1177/014556139807700708 ◽

1998 ◽

Vol 77 (7) ◽

pp. 534-537 ◽

Cited By ~ 19

Author(s):

Dean A. Drezner ◽

Harry Cantrell

Keyword(s):

Medical Center ◽

Surgical Approaches ◽

Fistula Closure ◽

Operative Techniques ◽

Tracheotomy Tube ◽

Respiratory Compromise ◽

Closure Technique ◽

Healing By Second Intention ◽

Flap Closure

Tracheocutaneous fistula (TCF) is a complication of tracheotomy that adds a difficult and bothersome aspect to the patient's care and may exacerbate respiratory disease. Closure of the fistula is recommended, but complications associated with fistula closure include pneumothorax and respiratory compromise. Several surgical approaches have been advocated in the literature. We reviewed the operative techniques and outcomes of TCF closures performed at Cooper Hospital/University Medical Center between February 1990 and April 1995. Direct, or flap, closure of large tracheocutaneous fistulas was associated with significant complications and morbidity. Therefore, the closure technique was modified so that we now recommend, in patients with large tracheocutaneous fistulas (a defect of the anterior tracheal wall of ≥4 mm diameter), excision of the fistula, replacement of the tracheotomy tube and healing by second intention after a short recannulation period. No complications have occurred since this closure technique was adopted.