Larynx and airway: persistent tracheocutaneous fistula: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

ENT · Larynx and airway: persistent tracheocutaneous fistula

Sample item

A child with a long-term tracheostomy has been decannulated. Three months later the stoma still leaks air and secretions. What is the appropriate treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Surgical excision of the tract with layered closure

A fistula persisting beyond a few months after decannulation rarely closes and needs excision of the epithelialised tract with layered closure. Repeated cautery is ineffective once the tract is lined with skin.

Option by option

  • A. Replacing the tube permanently

    Replacing the tube is unnecessary after successful decannulation.

  • B. Surgical excision of the tract with layered closure (correct)

    Correct. An epithelialised tract needs excision and layered closure.

  • C. Applying silver nitrate repeatedly

    Cautery does not close an epithelialised track.

  • D. Leaving it open indefinitely

    Leaving it open risks infection and aspiration.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More ENT questions

Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Surgical excision of the tract with layered closure. A fistula persisting beyond a few months after decannulation rarely closes and needs excision of the epithelialised tract with layered closure.

Why is "Replacing the tube permanently" not the answer?

Replacing the tube is unnecessary after successful decannulation.

Why is "Applying silver nitrate repeatedly" not the answer?

Cautery does not close an epithelialised track.

Why is "Leaving it open indefinitely" not the answer?

Leaving it open risks infection and aspiration.

What concept does this question test?

It tests Larynx and airway: persistent tracheocutaneous fistula in ENT. Repeated cautery is ineffective once the tract is lined with skin.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Larynx and airway: persistent tracheocutaneous fistula?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.