Powered debridement of suprastomal granulation tissue to facilitate pediatric tracheotomy decannulation.

Objective: To compare suprastomal granulation tissue (SSGT) removal using the microdebrider with other common methods of excision.

Methods: Retrospective review (n=21) of SSGT excision at a tertiary care pediatric hospital (2004-10). Outcome measures included intraoperative blood loss, operative time, decannulation rates, and complications.

Results: 10 children underwent excision of SSGT via powered SSGT debridement and 8 were decannulated (80% success rate). Of the other 11 patients who had manually non-powered techniques (kerrison rongeur, laryngeal microinstruments, or optical forceps), 7 were decannulated (63% success rate). Operative time was on average shorter than all other procedures, but not significantly (p=0.101). There was no significant difference in blood loss when powered debridement was compared to other techniques (p=0.872). There were no significant complications encountered in our patients who received SSGT powered debridement.

Conclusions: Endoscopic powered SSGT debridement is a simple and useful tool in the process of pediatric tracheotomy decannulation with superior decannulation rate, shorter operative time, and comparable blood loss to other techniques.