{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T21:38:06Z","timestamp":1768253886428,"version":"3.49.0"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T00:00:00Z","timestamp":1702512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the incidence of A\u2010frame deformity and suprastomal collapse after pediatric tracheostomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>Retrospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients (&lt;18\u2009years) that had a tracheostomy placed at a tertiary institution between 2015 and 2020 were included. Children without a surveillance bronchoscopy at least 6\u2009months after tracheostomy were excluded. Operative reports identified tracheal A\u2010frame deformity or suprastomal collapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 175 children met inclusion with 18% (<jats:italic>N<\/jats:italic>\u2009=\u200932) developing A\u2010frame deformity within a mean of 35.8\u2009months (SD: 19.4) after tracheostomy. For 18 children (18\/32, 56%), A\u2010frame developed within a mean of 11.3\u2009months (SD: 15.7) after decannulation. There were 96 children developing suprastomal collapse (55%) by a mean of 17.7\u2009months (SD: 14.2) after tracheostomy. All suprastomal collapse was identified prior to decannulation. Older age at tracheostomy was associated with a lower likelihood of collapse (OR: 0.92, 95% CI: 0.86\u20130.99, <jats:italic>p<\/jats:italic>\u2009=\u2009.03). The estimated 5\u2010year incidence of A\u2010frame deformity after tracheostomy was 32.8% (95% CI: 23.0\u201345.3) and the 3\u2010year incidence after decannulation was 36.1% (95% CI: 24.0\u201351.8). Highly complex children had an earlier time to A\u2010frame development (<jats:italic>p<\/jats:italic>\u2009=\u2009.04). At 5\u2009years after tracheostomy, the estimated rate of suprastomal collapse was 73.7% (95% CI: 63.8\u201382.8).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Tracheal A\u2010frame deformity is estimated to occur in 36% of children within 3\u2009years after tracheostomy decannulation. Suprastomal collapse, which approaches 74% at 5\u2009years after tracheostomy, is more common when tracheostomy is placed at a younger age. Surgeons caring for tracheostomy\u2010dependent children should recognize acquired airway obstruction and appropriately monitor these outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>3.<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.1202","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T04:53:40Z","timestamp":1702616020000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tracheal <scp>A<\/scp>\u2010frame deformity and suprastomal collapse after pediatric tracheostomy"],"prefix":"10.1002","volume":"9","author":[{"given":"Rishi","family":"Suresh","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\/0000-0002-3971-9405","authenticated-orcid":false,"given":"Helene","family":"Dabbous","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery West Virginia University  Morgantown West Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swapnika","family":"Alahari","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern School of Medicine  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":"Children's Medical Center Dallas, Department of Pediatric Otolaryngology  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":"Children's Medical Center Dallas, Department of Pediatric Otolaryngology  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; Neck Surgery University of Texas Southwestern Medical Center  Dallas Texas USA"},{"name":"Children's Medical Center Dallas, Department of Pediatric Otolaryngology  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30123"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200007000-00006"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0165-5876(89)90085-2"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.110533"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28996"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-020-06339-3"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.110427"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1992.01880120049010"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29402"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"issue":"2","key":"e_1_2_7_12_1","first-page":"154","article-title":"Tracheal stenosis after tracheostomy or intubation: review with special regard to cause and management","volume":"32","author":"Sarper A","year":"2005","journal-title":"Tex Heart Inst J"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.27.6.678"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2018.11.021"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2007.08.007"}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.1202","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T12:12:56Z","timestamp":1708690376000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.1202"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,14]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/lio2.1202"],"URL":"https:\/\/doi.org\/10.1002\/lio2.1202","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"value":"2378-8038","type":"print"},{"value":"2378-8038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,14]]},"assertion":[{"value":"2023-08-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e1202"}}