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Tracheostomy and Charge

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hi friends,

i am back in circulation. thx for ur hospitality in houston. again, i have

learnt so much from the children and their families. Brownie Shott and her

team needs a brownie medal for their sterling effort. a grand slam

performance so to speak! i hope Indianapolis can measure up in 2001.

There is only one published study from France that addresses trach in

children with charge. I have a copy of the whole article. the abstract can

be viewed at http://www.websciences.org/cftemplate/NAPS/indiv.cfm?ID=19990577.

my personal view is :

very few children need trachs - only 2 in Oz that i know of

as soon as it is inserted there should be a commmitted effort in a few

months to decannulate

it is invasive surgery and increases morbidity and mortality

it prolongs hospitalisation and adds to burdens of home and respite care

it interferes with the acquisition of oral communication

my indications would be :

a patent and safe airway that cannot be attained by oral suctioning,

tracheoplasty for tracheomalalacia, gastrostomy and fundoplication.

abnormal larynx which is does not provide protection for lungs from

aspiration and infection.

I hope this helps.

At 10:15 PM 21/09/99 -0600, you wrote:

>

>

>Meg,

>I really appreciate your response on this. It is nice to have accurate

information. Thanks.

>

>mom to (7 1/2 mo) CHaRGE

>

>Meg Hefner wrote:

>

>>

>>

>> I checked with the data from (old) questionnaires,

>> which I reported at the 1993 St. Louis

>> conference. In our survey, we had 19% of children

>> had trachs. Kim Blake reported 14% in the UK.

>> That very likely reflects the phiosophical

>> differences between US and UK. I would also

>> expect my survey may be an under-estimate, as most

>> parents fill it out when the child is quite young

>> and some kids don't get a trach until later. So

>> my best exitmate is that, in the US, between 20%

>> and 30% of kidds with CHARGE get a trach at some

>> point. Lots, but no where near the number quoted

>> by the ENT.

>> Meg

>>

>> Meg Hefner MS

>> Genetic Counselor

>> St. Louis MO

>> meg@...

>>

>> > For information about the CHARGE Syndrome Foundation or to become a

member please contact marion@....

>

>

>>For information about the CHARGE Syndrome Foundation or to become a member

please contact marion@....

>

>

L

Paediatrician

PO Box 248

Menai, Sydney, NSW 2234

Australia

Ph +061 02 9543 0222

Fax +061 02 9543 0510

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