Abstract: Objective This study aims to explore the clinical characteristics and outcomes of children who underwent tracheostomy after posterior cranial fossa tumor resection. Methods A retrospective analysis was conducted on 26 pediatric cases that underwent tracheostomy due to posterior fossa tumors. The following data were collected and analyzed: basic patient information, postoperative intubation duration, postoperative respiratory and swallowing conditions, tracheotomy indications, tracheotomy complications, and tracheotomy duration. Patients were observed for at least one year, with follow-ups conducted in outpatient settings or via telephone. Results This study included a total of 26 patients, consisting of 19 males and 7 females. The patients’ ages of the patients ranged from 1 to 13 years old, with an average age of(4.60±3.08)years. The tumor locations were as follows: the fourth ventricle/vermis of the cerebellum in 15 cases, the medulla oblongata and brainstem in 7 cases, the pons in 2 cases, the jugular foramen area in 1 case, and the cerebellar hemisphere in 1 case. Postoperative pathology results were as follows: astrocytoma in 6 cases, ependymoma in 8 cases, meningioma 1 case, craniopharyngioma 1 case, lipoma 1 case, and medulloblastoma in 9 cases. The tracheotomy operation was performed in 25 children for the purpose of persistent mechanical ventilation. The average duration of anesthetic intubation was 14 days. One child was extubated post-surgically but subsequently underwent tracheotomy one month after the operation due to breathing difficulties. Of the 26 patients, two were lost to follow-up, two died, thirteen underwent decannulation, and nine did not. The mean duration of tracheotomy tube usage was 7.8 months. Thirteen children received nasal feeding due to swallowing problems. There were two cases of left vocal cord paralysis, two cases of right vocal cord paralysis, and four cases of bilateral vocal cord paralysis. No patient experienced complications within a period of two weeks following their tracheotomy surgery. Following-decannulation, there were no complications related to tracheal stenosis or tracheomalacia. Conclusion The safety and efficacy of tracheotomy in children diagnosed with posterior cranial nerve dysfunction following surgical intervention for posterior cranial fossa tumors has been well-documented. Children who undergo tracheotomy after posterior cranial fossa tumor surgery require regular evaluation for respiratory and swallowing recovery. The timing of decannulation should be determined based on the individual situation of the child.

Key words: Tracheotomy, Posterior cranial fossa tumor, Children, Posterior cranial nerves dysfunction