International Pediatric Otolaryngology Group (IPOG) consensus recommendations: Management of suprastomal collapse in the pediatric population

Jaime Doody*, Ahmed Alkhateeb, Karthik Balakrishnan, Joshua Bedwell, John Carter, Sukgi S. Choi, Alan T. Cheng, Sam J. Daniel, John Dahl, Alessandro De Alarcon, Pierre Fayoux, Catherine K. Hart, Christopher Hartnick, Nico Jonas, Michael Kuo, Nikki Mills, Harlan Muntz, Richard Nicollas, Seth Pransky, Roger NussEvan J. Propst, Reza Rahbar, Marie Eva Rossi, Michael J. Rutter, Kishore Sandu, Douglas R. Sidell, Christian Sittel, Richard J.H. Smith, Marlene Soma, Jorge Spratley, Briac Thierry, Dana Thompson, Karen Watters, Todd Wine, Michelle Wyatt, George Zalzal, Carlton J. Zdanski, Karen B. Zur, John Russell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Introduction: Suprastomal Collapse (SuStCo) is a common complication of prolonged tracheostomy in children. There is a paucity of literature on this subject, especially regarding how to manage significant suprastomal collapse that prevents safe decannulation. Objective: Provide a definition, classification system, and recommend management options for significant suprastomal collapse in children with tracheostomy. Methods: Members of the International Pediatric Otolaryngology Group (IPOG) who are experts in pediatric airway conditions were surveyed and results were refined using a modified Delphi method. Results: Consensus was defined as > 70% agreement on a subject. The experts achieved consensus: • on a standard definition of Suprastomal Collapse • that there is clinical importance between significant and insignificant collapse • that the gold standard diagnostic modality is endoscopic examination under anesthesia • that the severity of collapse is a major determinant in the surgical approach • that surgical intervention is the first line management in combined anterior and lateral Suprastomal Collapse. Conclusion: This consensus statement provides recommendations for medical specialists who manage infants and children with tracheostomies with significant Suprastomal Collapse. It provides a classification system to facilitate diagnosis and treatment options for this condition.

Original languageEnglish (US)
Article number110427
JournalInternational journal of pediatric otorhinolaryngology
StatePublished - Dec 2020
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Otorhinolaryngology


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