Within the frame of intensive care we do no longer use the conventional tracheostomy but the so called "sewed-up tracheostomy". Between January 1971 until November 1973 31 children of all age-groups were treated by that method. Special care for patients with sewed-up tracheostoma is obviously facilitated. The replacement of cannulas has become easy. Plastic closure after decannulation offers good functional and cosmetic results. Surgical techniques, indications and criteria for institution and closure of the tracheostomas are described and 31 cases are evaluated. Complications occuring during the period of tracheostoma and subsequent to the plastic closure as well as the general fate of the children are reported.