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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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Acknowledgements

This study was supported by a grant for a Research Project for Intractable Diseases by the Ministry of Health, Labor and Welfare in Japan (Grant no. 26070201) received by N.U., and by the Practical Research Project for Rare/Intractable Disease from Japan Agency for Medical Research and Development, AMED, received by A.F.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Tokai University School of Medicine, Shimokasuya 143, Isehara, Kanagawa, Japan

    Shigeru Ueno

  2. Department of Pediatric Surgery, National Center for Child Health and Development, 2-10-1, Okura Setagaya-ku, Tokyo, Japan

    Akihiro Fujino

  3. Department of Pediatric Surgery, International University of Health and Welfare, Iguchi 537-3, Nasushiobara, Tochigi, Japan

    Yasuhide Morikawa

  4. Department of Pediatric Surgery, The University of Tokyo Faculty of Medicine, Hongo 7-3-1, Bunkyo-ku, Tokyo, Japan

    Tadashi Iwanaka

  5. Department of Pediatric Surgery, Niigata University School of Medicine, 757 Ichibancho, Asahimachi-dori, Chuo Ward, Niigata, Japan

    Yoshiaki Kinoshita

  6. Department of Pediatrics, Gifu University Hospital, 1-1, Yanagido, Gifu, Japan

    Michio Ozeki

  7. Department of Radiology, National Center for Child Health and Development, 2-10-1, Okura Setagaya-ku, Tokyo, Japan

    Shunsuke Nosaka

  8. Department of Pathology, Dokkyo Medical University Koshigaya Hospital, 2-1-50, Minami-Koshigaya, Koshigaya, Saitama, Japan

    Kentaro Matsuoka

  9. Department of Pediatric Surgery, Osaka Women’s and Children’s Hospital, 840, Murodocho, Izumi, Osaka, Japan

    Noriaki Usui

Authors
  1. Shigeru Ueno
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  2. Akihiro Fujino
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  3. Yasuhide Morikawa
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  4. Tadashi Iwanaka
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  5. Yoshiaki Kinoshita
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  6. Michio Ozeki
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  7. Shunsuke Nosaka
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  8. Kentaro Matsuoka
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  9. Noriaki Usui
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Corresponding author

Correspondence to Shigeru Ueno.

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Ueno, S., Fujino, A., Morikawa, Y. et al. Indications for tracheostomy in children with head and neck lymphatic malformation: analysis of a nationwide survey in Japan. Surg Today 49, 410–419 (2019). https://doi.org/10.1007/s00595-018-1755-3

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  • DOI: https://doi.org/10.1007/s00595-018-1755-3

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