Tracheostomy in Oral and Maxillofacial Surgery: indications and techniques.

Authors

  • Oluleke OO Department Of Surgery, Kaduna State University

DOI:

https://doi.org/10.60787/tnhj.v24i2.833

Keywords:

Tracheostomy, maxillofacial, surgery, indications, techniques, airway

Abstract

Background: Tracheostomy as a common surgical procedure in maxillofacial surgery is indicated in difficult intubation, severe orofacial infections, neoplasms, traumatic respiratory obstruction and congenital orofacial malformations. Study reviewed the indications and techniques used for tracheostomy in maxillofacial surgical patients in a teaching hospital.

Method: This was a retrospective study of the clinical aspects, treatment methods, and clinical course of 54 patients who underwent tracheostomies by a consultant in the Dental/Maxillofacial Clinic of Barau Dikko Teaching Hospital, between January, 2010 and April, 2024. Data collected from the accident and emergency, theatre and outpatient clinic registers, included patient age, clinical diagnosis, indications for tracheostomy, surgical procedures performed and complications.

Result: 54 patients had tracheostomy as elective and emergency surgeries during the period. Male to female ratio was 1.25: 1.00. Commonest indications was ankylosis of the temporomandibular joints (n=16, 29.63%), then massive tumors of the mandible (n= 12, 22.22%); panfacial fractures was the least (n=2, 3.70%). Elective surgeries (n=45, 83.33%) were the commonest interventions. Unilateral and bilateral condylectomies were the commonest procedures done (n=12, 22.22%). Intraoperative complications include bleeding and paratracheal placement of tube. Postoperative complications include blockage of tube with secretions and blood clot; subcutaneous surgical emphysema was significant in few patients after closure of the tracheostomy site. No patient had tracheal stenosis and the wound healed satisfactorily.

Conclusion: The standardized surgical technique presented here reduces the associated surgical risk. Maxillofacial surgeons need to be proficient in tracheostomy. Good knowledge of anatomy of important structures and handling them correctly greatly reduces complications.

Downloads

Download data is not yet available.

References

Gysin C, Dulguerov P, Guyot JP, Perneger TV. Abajo B, Chevrolet JC.

Percutaneous versus surgical tracheostomy. Ann Surg. 1999; 230 (5): 78-79.

Crosher R, Baldie C, Mitchell R. Selective use of trachestomy in surgery for head and neck cancer: An audit. Br J oral Maxillofac Surg. 1997; 35:43-45.

Casting B, Telfar M, Avery BS. Complication of tracheostomy in major head and neck cancer surgery: A retrospective study of 60 consecutive cases. Br J oral Maxillofac Surg. 1994:32:3-5.

Halfpenny W, McGurck M. Analysis of Tracheostomy-associated morbidity after operations for head and neck cancer. Br J Oral Maxillofac Surg. 2000; 38:509-12.

Barak M, Bahouth H, Leiser Y, El-Naaj I. Airway management of the patient with maxillofacial trauma: Review of the literature and suggested clinical approach. Biomed Res Int 2015; doi: 10.1155/2015/724032.

MittalG, Mittal RK, Katyal S, Uppal S, Mittal V. Airway management in maxillofacial trauma: do we really need tracheostomy? Submental intubation. J Can Clin Diag Res 2014; 8(3): 77-79.

Anehosur VS, Karadiguddi P, Joshi VK, Lakkundi BC, Ghosh R et al. Elective tracheostomy in head and surgery; our experience. J Clin Diagn Res 2017; 11(5): ZC36-ZC39.

Waldron J, Padgham ND, Hurley SE. Complications of emergency and elective tracheostomy: A retrospective study of 150 consecutive cases. Ann R Coll Surg Engl. 1990;72: 218-220.

Aicher S, Givol N, Peleg M, Ardekian L. Changing Indications for tracheostomy in Maxillofacial trauma. J Oral Maxillafac Surg. 1996; 54: 292-96.

Scutz P, Hamed H. Submental Intubation versus tracheostomy in maxillofacial trauma patients. J Oral Maxillofac Surg. 2008; 66:1404-09.

Ong SK, Morton RP, Kolbe J, Whitlock RM, Mclvor NP, Pulmonary complications following major head and neck surgery with tracheostomy: A prospective randomized, controlled trial of prophylactic antibiotics. Arch Otolaryngol Head Neck Surg. 2004; 130:1084-87.

Phero JC, Rosenberg MB, Giovannitti JA. Adult airway evaluation in oral surgery. Oral Maxillofac Surg Clin North Am. 2013; 25: 385-899.

Kenan PD. Complications associated with tracheostomy: prevention and treatment. Otolaryngol Clin North Am. 1979; 12: 807 -816

Downloads

Published

2024-06-10

How to Cite

Oluleke, O. O. (2024). Tracheostomy in Oral and Maxillofacial Surgery: indications and techniques. The Nigerian Health Journal, 24(2), 1327–1332. https://doi.org/10.60787/tnhj.v24i2.833
Abtract Views | PDF Download | EPUB Download: 189 / 96 / 44

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.