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

Author(s):  
Nina Shapiro ◽  
Victor Duarte
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

Author(s):  
PRAMOD CHIRAKKAL ◽  
Amira Al Hail

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.


2013 ◽  
Vol 149 (5) ◽  
pp. 766-771 ◽  
Author(s):  
Alexander J. Osborn ◽  
Alessandro de Alarcón ◽  
Catherine K. Hart ◽  
Robin T. Cotton ◽  
Michael J. Rutter

Author(s):  
Christopher H. Azbell ◽  
Anna Bakeman ◽  
Jennifer L. McCoy ◽  
Allison B.J. Tobey

2019 ◽  
Vol 12 (6) ◽  
pp. e229526 ◽  
Author(s):  
Robert J Lewis ◽  
Ari G Mandler ◽  
Geovanny Perez ◽  
Pamela A Mudd

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.


Children ◽  
2020 ◽  
Vol 7 (4) ◽  
pp. 26
Author(s):  
Ahana Yogesh ◽  
Michael Taylor ◽  
and Mary P. Chang

Saipan is a United States (US) territory Western Pacific island where little recent data exists regarding epidemiology, clinical presentation, and standard of care for pediatric seizures. This paper characterizes these features in Saipan’s pediatric population with comparisons to mainland US. This is a retrospective chart review of all pediatric patients with a history of seizures at the island’s only hospital and major private neurology clinic over a 10-year period. Variables regarding demographics, presentation, diagnosis, and treatment were collected. A total of 144 patients were included, with 101 patients diagnosed with febrile seizures and 31 patients diagnosed with non-febrile seizures. Age at first presentation peaked at 1 year old overall. The most common identified etiology of epilepsy was found to be hypoxic injury (39%), hemorrhagic injury (10%), cerebral malformation (6%), and brain mass (6%). Simple versus complex classification of febrile seizures, etiologies, and first-line treatment for non-febrile seizures were comparable to the mainland US. Electroencephalogram (EEG) was not used consistently in diagnosis. The findings from this study demonstrate that clinical presentations of pediatric seizures in Saipan are comparable to those in the mainland US.


2015 ◽  
Vol 19 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Adam A. Dmytriw ◽  
Wojciech Morzycki ◽  
Peter J. Green

Background: Chemotherapy-induced alopecia is one of the most distressing side effects of cancer treatment. Although there have been a number of investigated strategies to reduce this, there is no standard of care for treatment. Objective: This review aims to summarize the relevant evidence for the treatments available for chemotherapy-induced alopecia. Methods: A literature search using PubMed and the MEDLINE subengine was completed. The terms “chemotherapy,” “alopecia,” “quality of life,” and “strategies” were used, and articles from the last 10 years were considered. The pediatric population was not investigated. Results: Physical therapies for alopecia prevention have shown some promise but range from insufficient to detrimental depending on the type of cancer. Cold caps may be more effective than tourniquets and may be associated with fewer metastatic events. Pharmacologic therapies, both immunomodulators and growth factors, have stood the test of several trials to date. In particular, cyclosporine has been shown either to prevent alopecia or promote hair growth during a chemotherapy regimen. Conclusion: Although the evidence is not yet overwhelming, it is becoming clear that a combination of mechanical and chemical interventions may help compensate for the downfalls of either therapy alone.


2019 ◽  
Vol 125 ◽  
pp. 122-127 ◽  
Author(s):  
Benjamin L. Wisniewski ◽  
Emily L. Jensen ◽  
Jeremy D. Prager ◽  
Todd M. Wine ◽  
Christopher D. Baker

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