The timing of tracheostomy extubation in head and neck cancer patients

Tracheostomy is an effective and secure airway for head and neck cancer patients intraoperatively and postoperatively. During this study period of February 2001–July 2010, we reviewed 209 tracheostomies on oral cancer patients. Besides, we changed our philosophy of timing of decannulation in December 2004. Before then, most of the extubation was within 7 days (Goup 1). After December 2004, we extended the extubation to 11–18 days (Group 2). The tracheostomy-related complications between different timing of decannulation will be presented. Univariate statistical analysis was performed using Mann–Whitney’s test to evaluate the risk factors in relation to the rate of tracheostomy complications.

This analysis included 178 tracheostomies performed on 152 cancer patients. The average timing of decannulation was 14.06 days, while the average hospitalization was 29.01 days. The complication rate related to tracheostomy was 41.57%, which can be classified into 6 types. No death related to tracheostomy occurred. Delayed decannulation was impacted by double flap transfers, postoperative wound infection, and tracheostomy complications in univariate analysis. When comparing the two groups, the average timing of decannulation in Group 2 was extended to approximate 6 days (15.05 days in Group 2 vs 9.68 days in Group 1). This reflects totally different results. The average hospital stay was 22.19 days in Group 1 but 30.45 days in Group 2. However, the tracheostomy complications rate decreased from 62.5% to 30.86%.

Postoperative wound infection and tracheostomy-related complications will influence the timing of decannulation. If we lengthen the timing of extubation, the related complications can drop dramatically.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on The timing of tracheostomy extubation in head and neck cancer patients
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