Pediatric tracheostomy

Tracheotomy is most commonly performed in children who are less than 1 year of age. The most common indication is for prolonged ventilatory support secondary to lung disease of prematurity. Tracheotomy is also performed for children with anatomic upper airway obstruction or children with neurodevelopmental delay who require pulmonary toilet. Surgical approaches to tracheotomy are designed to minimize trauma, establish a mature tracheocutaneous fistula, and avoid devastating postoperative complications, such as accidental decannulation. This article details a straightforward stepwise surgical approach to tracheotomy in children.