Indications for tracheostomy in children with head and neck lymphatic malformation: analysis of a nationwide survey in Japan.
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| Abstract | PURPOSE:
Airway obstruction caused by lymphatic malformation (LM) in the head and neck may require a tracheostomy. We present the results of our analysis of a nationwide survey on the indications for tracheostomy in children with head and neck LM. METHODS: We analyzed data in relation to tracheostomy based on a questionnaire about 518 children with head and neck LM without mediastinal involvement. RESULTS:
Tracheostomy was performed for 43 of the 518 children. Most (32/43) of these children were younger than 1 year of age and the tracheostomy was almost always performed for airway obstruction (40/43). The lesion was in contact with the airway in 32 (72%) of these children, but in only 58 (12%) of the 473 children who were managed without tracheostomy. When the maximum circumferential area of contact was compared, only 20 (27%) of 74 patients with maximum contact of less than a half-circle required tracheostomy, whereas 11 of 13 with maximum contact of more than a half-circle required tracheostomy (P = 0.0001). Six patients without airway contact required tracheostomy because of acute swelling caused by hemorrhage, infection, or both. CONCLUSIONS: Children with head and neck LM required tracheostomy to relieve airway obstruction. Tracheostomy should be considered if the lesion is in contact with the airway and surrounds more than a half-circle, and when it causes acute swelling.
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| Authors | Shigeru Ueno, Akihiro Fujino, Yasuhide Morikawa, Tadashi Iwanaka, Yoshiaki Kinoshita, Michio Ozeki, Shunsuke Nosaka, Kentaro Matsuoka, Noriaki Usui |
| Journal | Surgery today (Surg Today) Vol. 49 Issue 5 Pg. 410-419 (May 2019) ISSN: 1436-2813 [Electronic] Japan |
| PMID | 30778735 (Publication Type: Journal Article) |
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