Paediatric tracheostomy: a unique situation in a tertiary children’s hospital in Sabah, Malaysia




Tracheostomy, Paediatric, Sabah, Immigrants


Background: This paper presents our experience in paediatric tracheostomy in a tertiary children’s hospital and to describe the unique multi-racial and multi-ethnic social demographics involved. Moreover, we would like to highlight an unusual social concern in the state of Sabah, Malaysia and its challenges when treating illegal immigrant children.

Methods: A retrospective case note review was conducted for all paediatric patients who underwent tracheostomy between January 2014 to December 2018.

Results: Seventy-six patients were recruited. Among them thirteen (17.1%) were illegal immigrant children. The commonest indication for tracheostomy was for prolonged assisted ventilation (60.5%), followed by upper airway obstruction (38.2%) and bronchial toileting (1.3%).

Conclusions: This study reflects the current trend in regards to the indication for paediatric tracheostomy. The challenges in treating illegal immigrant children need to be considered on a case by case basis encompassing the family’s economic situation, hospital policies and the child well-being.


Line WS, Hawkins DB, Kahlstrom EJ, Maclaughlin EF, Ensley JL. Tracheotomy in infants and young children: The changing perspective 1970–1985. The Laryngoscope. 1986;96(5):510-5.

Carron JD, Derkay CS, Strope GL, Nosonchuk JE, Darrow DH. Pediatric Tracheotomies: Changing Indications and Outcomes. The Laryngoscope. 2000;110(7):1099-104.

Lawrason A, Kavanagh K. Pediatric tracheotomy: are the indications changing? Int J Pediatr Otorhinolaryngol. 2013;77(6):922-5.

Fields AI. Pediatric tracheostomy: the great liberator or the last battlefield? Pediatr Crit Care Med. 2008;9(1):126-7.

Zenk J, Fyrmpas G, Zimmermann T, Koch M, Constantinidis J, Iro H. Tracheostomy in young patients: indications and long-term outcome. Eur Arch Otorhinolaryngol. 2009;266(5):705-11.

Gerson CR, Tucker GF Jr. Infant tracheostomy. Ann Otol Rhinol Laryngol. 1982;91:413-416.

Alladi A, Rao S, Das K, Charles AR, D’Cruz AJ. Pediatric tracheostomy: a 13-year experience. Pediatr Surg Int. 2004;20(9):695-8.

Wetmore RF, Handler SD, Potsic WP. Pediatric tracheostomy. Experience during the past decade. Ann Otol Rhinol Laryngol. 1982;91(6 Pt 1):628-32.

Gaudet PT, Peerless A, Sasaki CT, Kirchner JA. Pediatric tracheostomy and associated complications. The Laryngoscope. 1978;88(10):1633-41.

Kremer B, Botos-Kremer AI, Eckel HE, Schlöndorff G. Indications, complications, and surgical techniques for pediatric tracheostomies--an update. J Pediatr Surg. 2002;37(11):1556-62.

Lewis CW, Carron JD, Perkins JA, Sie KCY, Feudtner C. Tracheotomy in pediatric patients: a national perspective. Arch Otolaryngol Head Neck Surg. 2003;129(5):523-9.

Putra SHAP, Wong CY, Hazim MYS, Shiraz MARM, Goh BS. Paediatric tracheostomy in Hospital University Kebangsaan Malaysia - A changing trend. MED J MALAYSIA, The Medical journal of Malaysia, The Medical journal of Malaysia. 2006;61(2):209-13.

Onotai, L.O, Etawo, U.S. An audit of paediatric tracheostomies in Port Harcourt Nigeria. International Journal of Medicine and Medical Sciences. 2012;2:147-53.

Onyeagwara NC, Emokpaire EO. Pattern of pediatric tracheostomy at university of Benin teaching hospital, Benin city: A ten-year review. Arch Int Surg. 2014;4:167-71.

Lasimbang HB, Tong WT, Low WY. Migrant workers in Sabah, East Malaysia: The importance of legislation and policy to uphold equity on sexual and reproductive health and rights. Best Pract Res Clin Obstet Gynaecol. 2016;32:113-23.

Hadfield PJ, Lloyd-Faulconbridge RV, Almeyda J, Albert DM, Bailey CM. The changing indications for paediatric tracheostomy. IntJ Pediatr Otorhinolaryngol. 2003;67:7-10.

Ward RF, Jones J, Carew JF. Current trends in paediatric tracheostomy. Int J Pediatr Otorhinolaryngol. 1995;32:233-9.

Corbett HJ, Mann KS, Mitra I, Jesudason EC, Losty PD, Clarke RW. Tracheostomy--a 10-year experience from a UK pediatric surgical center. J Pediatr Surg. 2007;42(7):1251-4.

Mahadevan M, Barber C, Salkeld L, Douglas G, Mills N. Pediatric tracheotomy: 17 year review. Int J Pediatr Otorhinolaryngol. 2007;71(12):1829-35.

Al-Samri M, Mitchell I, Drummond DS, Bjornson C. Tracheostomy in children: a population-based experience over 17 years. Pediatr Pulmonol. 2010;45(5):487-93.

Eziyi JA, Amusa YB, Musa IO, Adeniji AO, Olarinoye OT, Ameye SA. Tracheostomy in south Western Nigeria: Any change in pattern? J Med Med Sci. 2011;2:997-1002.






Original Research Articles