In the early 15th century, Italian physician Antonio Musa Brasslova performed the first successful tracheostomy procedure to relieve airway obstruction caused by enlarged tonsils. Standardized in the early 1900s by otolaryngologist Chevalier Jackson, the procedure is now used frequently in the pediatric population to provide a safe airway for children with respiratory compromise or failure or those with airway obstruction. Of the 100 000 tracheostomies performed annually, approximately 4000 are performed on children, with one-third on infants, specifically premature infants. The availability of technically advanced ventilation equipment for invasive and noninvasive airway management has allowed many more infants and children to survive a serious illness than in the past. Many children require prolonged intubation as a result of chronic respiratory failure and inability to wean from ventilator support, contributing to acquired tracheomalacia (breakdown of the rigid tracheal structures) and acquired subglottic stenosis (weakening of the area...

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