factors associated with fracture and migration of tracheostomy tube into trachea in children: a case series

Introductiontracheostomy is done to bypass the obstructed upper airway. rare complication of this procedure is the fracture of the tube. early identification and management of this condition is a great challenge to an otolaryngologist. to study the factors associated with the fracture and migration of tracheostomy tube into tracheobronchial tree in paediatric age group. materials and methods:this study is a case series study conducted on children with a diagnosis of fractured tracheostomy tube presenting as a foreign body airway over five years duration. data regarding the possible patient and tube factors responsible for the condition were collected and analysed. results:total 11 patients (males-5 and females-6, average age-10.18 years, range 1-15 years) wearing tracheostomy tube for an average period of 2 years (range 3 months-8 years) were included in the study. aspirated tubes were jackson’s metallic inner tube, romson polyvinyl chloride plastic tube and fuller’s outer tube flange in 5 (45.5%), 4 (36.4%) and 2 (18.1%) patients respectively. the most common fracture site was at the junction between tube and neck plate (90.9%). the most common causes for fracture tube were prolonged use in 10 cases (90.9%), stomal narrowing in 9 cases (81.8%), and infection with peri-stomal granulation tissue in 9 cases (81.8%).  conclusion:a fractured tracheostomy tube is a rare but preventable late complication of tracheostomy. appropriate training about proper tracheostomy care, timely check-up of tracheostomy tube for signs of wear and tear, scheduled replacement, regular follow up and awareness may prevention this complication.