Surveillance endoscopy in pediatric tracheostomy: A systematic review.

TitleSurveillance endoscopy in pediatric tracheostomy: A systematic review.
Publication TypeJournal Article
Year of Publication2021
AuthorsBahri KAl, C Liu C
JournalInt J Pediatr Otorhinolaryngol
Date Published2021 Jan
KeywordsChild, Dilatation, Endoscopy, Humans, Laryngostenosis, Retrospective Studies, Tracheostomy

OBJECTIVES: To systematically review the literature on the yield of surveillance airway endoscopy in pediatric patients with tracheostomies.

METHODS: A systematic search was performed according to PRISMA guidelines of the MEDLINE/Pubmed and Embase databases. Data were collected on the following outcomes of interest: abnormal airway findings in surveillance endoscopy performed in pediatric tracheostomy patients, frequency and nature of interventions performed during endoscopy, and predictive factors associated with abnormal airway findings.

RESULTS: Seven studies were included in the review. The timing of endoscopy post-tracheostomy placement was variable and ranged from 1 to 24 months. All studies reported abnormal airway findings on initial endoscopic examination, with rates varying from 20 to 87%. Airway granulomas/granulation tissue was the most common finding, followed by airway stenosis and suprastomal collapse. Interventions performed to improve airway safety occurred in 18%-64% of patients undergoing surveillance endoscopy. The most commonly reported interventions were debridement of granulation tissue and dilation of subglottic stenosis. No endoscopy-related complications were reported across the studies. The presence of tracheostomy-related symptoms was the most consistently reported predictor of abnormal airway findings and airway interventions.

CONCLUSION: Pediatric tracheostomy patients undergoing surveillance airway endoscopy have a high rate of abnormal airway findings and interventions. However, additional studies are needed before routine endoscopy can be recommended in asymptomatic patients.

Alternate JournalInt J Pediatr Otorhinolaryngol
PubMed ID33296833
Faculty Reference: 
Che Carrie Liu, MD, MPH