Acute epiglottitis in children - the morbidity of management by elective tracheostomy.

Acute epiglottitis is a pediatric airway emergency. No deaths occurred in 61 cases treated by elective tracheostomy at The Montreal Children's Hospital between 1966 and 1974. Seven patients (11.5%) showed evidence of aspiration pneumonia prior to tracheostomy and seven others developed pulmonary atelectasis in the first 24 hours following tracheostomy but only 9.8% of the total had a complication which continued in evidence 24 hours following surgery. A further 19.5% developed further complications unrelated to this earlier morbidity prior to discharge from hospital. The mean cannulation time was seven days and the mean hospital stay was nine days. Of these patients, 32 (52.4%) were seen between a year and seven-and-a-half years later. Twenty were completely asymptomatic with a small, neat scar. Twelve patients had experienced some upper respiratory problem or minor problems related to the tracheostomy incision.