Introduction: In the nineteenth century tracheotomy was performed in case of diphtheria. In 1869 Trousseau presented data on 215 cases of this disease treated this way and it became an operation that was reserved for life threatening conditions. In 1907 Jackson presented his experience with tracheotomy and provided information on equipment and techniques that are still used nowadays.
Material and methods: A retrospective analysis was performed on 79 patients undergoing tracheotomy at Pediatric ENT Dept in Poznañ from 1995-2005. Charts were reviewed with respect to primary diagnosis and indication for tracheotomy.
Results: Approximately 56% of the tracheotomies were performed in infants, 18%--in neonates and 26% in children over 1 years old. The most common indication for this procedure in neonates was prolonged intubation--43% in neonates and 25% in infants. Congenital laryngotracheal anomalies were the second group of indications in neonates--28.5% cases and congenital heart anomalies in infants--22.7%. In children over 1 year of age the most common indication were respiratory failure--52.,4% and prolonged intubation in 14.3%.
Conclusions: Obvious anatomical differences between the larynx and trachea of the adult and the child necessitate different surgical techniques. It is important to perform tracheotomy over a bronchoscope or endotracheal tube when possible because of the malleability of the trachea in the child. After the tracheotomy tube is placed it is necessary to check its position and level with flexible bronchoscope.