Skip to main content

Starplasty: A new design for pediatric tracheostomy

Abstract

We are describing a new design of pediatric tracheostomy planned for long periods of time. The procedure entails creating a mature tracheo-cutaneous track through three dimensions Z-plasty design. This technique showed superiority to other currently available techniques in reducing the incidence of teacheostomy complications, specially serious hypoxemia after accidental deacannulation. However, this is on the expense of persistence of tracheo-cutaneous fistula after decanuulation.

References

  1. Jackson C. Tracheotomy. The Laryngoscope 1909; 19: 285–290.

    Google Scholar 

  2. de Trey L, Niedermann E, Ghelfi D, Gerber A, Gysin C. Pediatric tracheotomy: A 30-year experience. Journal of pediatric surgery 2013; 48: 1470–1475.

    Article  Google Scholar 

  3. Cochrane LA, Bailey CM. Surgical aspects of tracheostomy in children. Paediatric respiratory reviews 2006; 7: 169–174.

    Article  Google Scholar 

  4. Koltai PJ. Starplasty: a new technique of pediatric tracheotomy. Archives of otolaryngology — head & neck surgery 1998; 124: 1105–1111.

    Article  CAS  Google Scholar 

  5. Overman AE, Liu M, Kurachek SC, Shreve MR, Maynard RC, Mammel MC, et al. Tracheostomy for infants requiring prolonged mechanical ventilation: 10 years’ experience. Pediatrics 2013; 131:e1491–e1496.

    Article  Google Scholar 

  6. Keszler M. State of the art in conventional mechanical ventilation. Journal of perinatology: Official journal of the California Perinatal Association 2009; 29: 262–275.

    Article  CAS  Google Scholar 

  7. Estournet-Mathiaud B. Tracheostomy in chronic lung disease: Care and follow-up. Pediatric pulmonology 2001; 23: 135–136.

    Article  Google Scholar 

  8. Line WS, Jr., Hawkins DB, Kahlstrom EJ, MacLaughlin EF, Ensley JL. Tracheotomy in infants and young children: The changing perspective 1970–1985. The Laryngoscope 1986; 96:510–515.

    Article  Google Scholar 

  9. Colman KL, Mandell DL, Simons JP. Impact of stoma maturation on pediatric tracheostomy-related complications. Archives of otolaryngology — head & neck surgery 2010; 136: 471–474.

    Article  Google Scholar 

  10. Eliashar R, Gross M, Attal P, Hocwald E, Sichel JY. “Starplasty” prevents tracheotomy complications in infants. International journal of pediatric otorhinolaryngology 2004; 68:325–329.

    Article  Google Scholar 

  11. Solares CA, Krakovitz P, Hirose K, Koltai PJ. Starplasty: Revisiting a pediatric tracheostomy technique. Otolaryngology — head and neck surgery: Official journal of American Academy of Otolaryngology-Head and Neck Surgery 2004; 131:717–722.

    Article  Google Scholar 

  12. Wetmore RF, Handler SD, Potsic WP. Pediatric tracheostomy. Experience during the past decade. The Annals of otology, rhinology, and laryngology 1982; 91:628–632.

    Article  CAS  Google Scholar 

  13. Gilmore BB, Jr., Mickelson SA. Pediatric tracheotomy. Controversies in management. Otolaryngologic clinics of North America 1986; 19:141–151.

    PubMed  Google Scholar 

  14. Hotaling AJ, Robbins WK, Madgy DN, Belenky WM. Pediatric tracheotomy: A review of technique. American journal of otolaryngology 1992; 13:115–119.

    Article  CAS  Google Scholar 

  15. Waki EY, Madgy DN, Zablocki H, Belenky WM, Hotaling AJ. An analysis of the inferior based tracheal flap for pediatric tracheotomy. International journal of pediatric otorhinolaryngology 1993; 27:47–54.

    Article  CAS  Google Scholar 

  16. Hewlett AB, Ranger D. Tracheostomy. Postgraduate medical journal 1961; 37:18–21.

    Article  CAS  Google Scholar 

  17. Gaudet PT, Peerless A, Sasaki CT, Kirchner JA. Pediatric tracheostomy and associated complications. The Laryngoscope 1978; 88:1633–1641.

    Article  CAS  Google Scholar 

  18. Craig MF, Bajaj Y, Hartley BE. Maturation sutures for the paediatric tracheostomy — an extra safety measure. The Journal of laryngology and otology 2005; 119:985–987.

    Article  CAS  Google Scholar 

  19. Park JY, Suskind DL, Prater D, Muntz HR, Lusk RP. Maturation of the pediatric tracheostomy stoma: Effect on complications. The Annals of otology, rhinology, and laryngology 1999; 108:1115–1119.

    Article  CAS  Google Scholar 

  20. Carter P, Benjamin B. Ten-year review of pediatric tracheotomy. The Annals of otology, rhinology, and laryngology 1983; 92:398–400.

    Article  CAS  Google Scholar 

  21. Prescott CA. Peristomal complications of paediatric tracheostomy. International journal of pediatric otorhinolaryngology 1992; 23:141–149.

    Article  CAS  Google Scholar 

  22. Pucher B, Szydlowski J, Ryglewicz M, Grzegorowski M. [“Starplasty” tracheotomy in children of Pediatric ENT Department of Poznan University of Medical Sciences]. Otolaryngologia polska The Polish otolaryngology 2013; 67:100–104.

    Article  Google Scholar 

  23. Bressler KL, Kaiser PC, Dunham ME, Holinger LD. Primary closure of persistent tracheocutaneous fistula in children. The Annals of otology, rhinology, and laryngology 1994; 103:835–837.

    Article  CAS  Google Scholar 

  24. Keenan JP, Snyder GG, 3rd, Lehmann WB, Ruiz JW. Management of tracheocutaneous fistula. Archives of otolaryngology 1978; 104:530–531.

    Article  CAS  Google Scholar 

  25. Sautter NB, Krakovitz PR, Solares CA, Koltai PJ. Closure of persistent tracheocutaneous fistula following “Starplasty” tracheostomy in children. International journal of pediatric otorhinolaryngology 2006; 70:99–105.

    Article  Google Scholar 

  26. Tucker JA, Silberman HD. Tracheotomy in pediatrics. The Annals of otology, rhinology, and laryngology 1972; 81:818–824.

    Article  CAS  Google Scholar 

  27. Kremer B, Botos-Kremer AI, Eckel HE, Schlondorff G. Indications, complications, and surgical techniques for pediatric tracheostomies — an update. Journal of pediatric surgery 2002; 37:1556–1562.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mostafa I. Ammar MSc.

Additional information

Conflicts of interest

None declared.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ammar, M.I., Elkawa, A.I., Elhamshary, A.S. et al. Starplasty: A new design for pediatric tracheostomy. Egypt J Otolaryngol 30, 183–187 (2014). https://doi.org/10.4103/1012-5574.133227

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1012-5574.133227

Keywords