{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:04:12Z","timestamp":1767830652030,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T00:00:00Z","timestamp":1652313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the incidence of tracheocutaneous fistula (TCF) and identify characteristics associated with persistence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All successfully decannulated children (&lt;18\u2009years) between 2014 and 2020 at a tertiary children's hospital were included. Revision tracheostomies, concomitant major neck surgery, or single\u2010stage laryngotracheal reconstructions were excluded. A persistent TCF was defined as a patent fistula at 6\u2009weeks after decannulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 77 children met inclusion criteria with a persistent TCF incidence of 65% (50\/77). Children with a persistent TCF were younger at placement (1.4\u2009years (SD: 3.3) vs. 8.5\u2009years (SD: 6.5), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and tracheostomy\u2010dependent longer (2.8\u2009years (SD: 1.3) vs. 0.9\u2009years (SD: 0.7), <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). On univariate analysis, placement under 12\u2009months of age (86% vs. 26% <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), duration of tracheostomy more than 2\u2009years (76% vs. 11% <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), short gestation (64% vs. 26%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002), congenital malformations (64% vs. 33%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02), newborn complications (58% vs. 26%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.009), maternal complications (40% vs. 11%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.009) and chronic respiratory failure (72% vs. 41%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.01) were associated with persistent TCF. Logistic regression analysis associated duration of tracheostomy (OR: 0.14, 95% CI: 0.05\u20130.35, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and congenital malformations (OR: 0.25, 95% CI: 0.06\u20130.99, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.049) with failure to spontaneously close.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Two\u2010thirds of children will develop a persistent TCF after tracheostomy decannulation. Persistent TCF is correlated with a longer duration of tracheostomy and congenital malformations. Anticipation of this event in higher\u2010risk children is necessary when caring for pediatric tracheostomy patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 133:417\u2013422, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30163","type":"journal-article","created":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T13:43:56Z","timestamp":1652363036000},"page":"417-422","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Incidence of Persistent Tracheocutaneous Fistula After Pediatric Tracheostomy Decannulation"],"prefix":"10.1002","volume":"133","author":[{"given":"Taylor B.","family":"Teplitzky","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6801-7544","authenticated-orcid":false,"given":"Yann\u2010Fuu","family":"Kou","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Texas Southwestern Medical Center  Dallas Texas USA"},{"name":"Department of Pediatric Otolaryngology Children's Medical Center Dallas  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4011-1111","authenticated-orcid":false,"given":"Dylan R.","family":"Beams","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2322-5347","authenticated-orcid":false,"given":"Romaine F.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Texas Southwestern Medical Center  Dallas Texas USA"},{"name":"Department of Pediatric Otolaryngology Children's Medical Center Dallas  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1419-6019","authenticated-orcid":false,"given":"Stephen R.","family":"Chorney","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; 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