International Pediatric Otolaryngology Group (IPOG) consensus recommendations: Management of suprastomal collapse in the pediatric population

Jaime Doody; Ahmed Alkhateeb; Karthik Balakrishnan; Joshua Bedwell; John Carter; Sukgi S Choi; Alan T Cheng; Sam J Daniel; John Dahl; Alessandro De Alarcon; Pierre Fayoux; Catherine K Hart; Christopher Hartnick; Nico Jonas; Michael Kuo; Nikki Mills; Harlan Muntz; Richard Nicollas; Seth Pransky; Roger Nuss; Evan J Propst; Reza Rahbar; Marie-Eva Rossi; Michael J Rutter; Kishore Sandu; Douglas R Sidell; Christian Sittel; Richard J H Smith; Marlene Soma; Jorge Spratley; Briac Thierry; Dana Thompson; Karen Watters; Todd Wine; Michelle Wyatt; George Zalzal; Carlton J Zdanski; Karen B Zur; John Russell

doi:10.1016/j.ijporl.2020.110427

International Pediatric Otolaryngology Group (IPOG) consensus recommendations: Management of suprastomal collapse in the pediatric population

Int J Pediatr Otorhinolaryngol. 2020 Dec:139:110427. doi: 10.1016/j.ijporl.2020.110427. Epub 2020 Oct 13.

Authors

Jaime Doody¹, Ahmed Alkhateeb², Karthik Balakrishnan³, Joshua Bedwell⁴, John Carter⁵, Sukgi S Choi⁶, Alan T Cheng⁷, Sam J Daniel⁸, John Dahl⁹, Alessandro De Alarcon¹⁰, Pierre Fayoux¹¹, Catherine K Hart¹⁰, Christopher Hartnick¹², Nico Jonas¹³, Michael Kuo¹⁴, Nikki Mills¹⁵, Harlan Muntz¹⁶, Richard Nicollas¹⁷, Seth Pransky¹⁸, Roger Nuss⁶, Evan J Propst¹⁹, Reza Rahbar⁶, Marie-Eva Rossi¹⁷, Michael J Rutter¹⁰, Kishore Sandu²⁰, Douglas R Sidell²¹, Christian Sittel²², Richard J H Smith², Marlene Soma²³, Jorge Spratley²⁴, Briac Thierry²⁵, Dana Thompson²⁶, Karen Watters⁶, Todd Wine²⁷, Michelle Wyatt²⁸, George Zalzal²⁹, Carlton J Zdanski¹, Karen B Zur³⁰, John Russell³¹

Affiliations

¹ Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
² Carver College of Medicine, Department of Otolaryngology-Head & Neck Surgery, University of Iowa, Iowa City, IA, USA.
³ Department of Otolaryngology - Head & Neck Surgery, Stanford University, Lucile Packard Children's Hospital, Palo Alto, CA, USA.
⁴ Division of Pediatric Otolaryngology, Texas Children's Hospital, Houston, TX, USA; Department of Otolaryngology, Baylor College of Medicine, Houston, TX, USA.
⁵ Ochsner Medical Center, 1514 Jefferson Hwy, New Orleans, LA, USA.
⁶ Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, MA, USA.
⁷ Department of Pediatric Otolaryngology, The Sydney Children's Hospital Network-Westmead Campus, The University of Sydney, Sydney, NSW, Australia.
⁸ Department of Otolaryngology - Head and Neck Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
⁹ Department of Surgery, Division of Otolaryngology, Seattle Children's Hospital, Seattle, WA, USA.
¹⁰ Division of Pediatric Otolaryngology, Aerodigestive and Sleep Center, Cincinnati Children's Hospital Medical Center, University of Cincinnati School of Medicine, Cincinnati, OH, USA.
¹¹ Department of Pediatric Otolaryngology Head Neck Surgery, Jeanne de Flandre Hospital, University, Hospital of Lille, Lille, France.
¹² Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
¹³ Department of Pediatric ENT, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
¹⁴ Birmingham Children's Hospital, Birmingham, United Kingdom.
¹⁵ Paediatric Otolaryngology Department, Starship Children's Hospital, Auckland, New Zealand.
¹⁶ Division of Otolaryngology-Head and Neck Surgery, Primary Children's Medical Center, University of Utah, Salt Lake City, UT, USA.
¹⁷ Department of Pediatric Otolaryngology Head and Neck Surgery, Aix-Marseille University, La Timone Children's Hospital, Public Hospitals of Marseille, Marseille, France.
¹⁸ Rady Children's Hospital, San Diego, CA, USA.
¹⁹ Department of Otolaryngology - Head & Neck Surgery, Hospital for Sick Children, University of Toronto, Canada.
²⁰ Lausanne University Hospital, CHUV, Switzerland.
²¹ Department of Otolaryngology, Head and Neck Surgery; Pediatric Aerodigestive and Airway Reconstruction Center, Stanford University, Stanford, CA, USA.
²² Klinik für Hals-, Nasen-, Ohrenkrankheiten, Plastische Operationen, Klinikum Stuttgart- Katharinenhospital, Stuttgart, Germany.
²³ Paediatric Otolaryngology, Sydney Children's Hospital, High St, Randwick, NSW, Australia.
²⁴ Section of Pediatric ORL, Department of ORL, University Hospital Center S. Joao, University of Porto Faculty of Medicine and CINTESIS, Porto, Portugal.
²⁵ Hôpital Universitaire Necker-Enfants-Malades, 149, rue de Sèvres, Paris, France.
²⁶ Division of Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
²⁷ Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA.
²⁸ Great Ormond Street Hospital for Children, London, United Kingdom.
²⁹ Department of Otolaryngology, Children's National Hospital, Washington, DC, USA.
³⁰ Division of Otolaryngology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
³¹ Children's Health Ireland (Crumlin), Dublin, Ireland.

PMID: 33120101
DOI: 10.1016/j.ijporl.2020.110427

Abstract

Introduction: Suprastomal Collapse (SuStCo) is a common complication of prolonged tracheostomy in children. There is a paucity of literature on this subject, especially regarding how to manage significant suprastomal collapse that prevents safe decannulation.

Objective: Provide a definition, classification system, and recommend management options for significant suprastomal collapse in children with tracheostomy.

Methods: Members of the International Pediatric Otolaryngology Group (IPOG) who are experts in pediatric airway conditions were surveyed and results were refined using a modified Delphi method.

Results: Consensus was defined as > 70% agreement on a subject. The experts achieved consensus: CONCLUSION: This consensus statement provides recommendations for medical specialists who manage infants and children with tracheostomies with significant Suprastomal Collapse. It provides a classification system to facilitate diagnosis and treatment options for this condition.

MeSH terms

Child
Consensus
Humans
Infant
Otolaryngology*
Tracheostomy* / adverse effects