Prevalence of Elective Tracheostomy Complications in Neck Dissection Patients

Tariq Mahmood; Shafi ullah  Khan; Sabir  Ali; Idrees  Khan; Shahid Iqbal  Khan; Muhammad  Junaid

doi:10.51253/pafmj.v76iSUPPL-1.13505

Authors

Tariq Mahmood Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Shafi ullah Khan Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Sabir Ali Department of Oral pathology, Liaquat University of Medical & Health Sciences, Jamshoro Pakistan
Idrees Khan Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Shahid Iqbal Khan Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Muhammad Junaid Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-1.13505

Keywords:

Airway management, Elective tracheostomy, Neck dissection, Postoperative complications, Tracheostomy care, Tracheostomy complications

Abstract

Objective: To evaluate the incidence and nature of complications associated with elective tracheostomy in patients undergoing neck dissection.

Study Design: Descriptive Analytical Observational Study.

Place and Duration of Study: Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Jan to Dec 2024.

Methodology: A total of 60 patients were analyzed in the final study protocol undergoing neck dissection. Primary variables studies were frequency of tracheostomy associated complications after neck dissection and reconstruction in the immediate, short and long term follow-up.

Results: Immediate tracheostomy complications included bleeding in 07(11.6%) patients and surgical emphysema in 02(3.4%) patients. Short term complications included tube related issues in 04(6.6%), infection in 05(8.4%) and dysphagia in 02(3.4%) patients. Long term complications showed tracheal stenosis in 01(1.6%) and tracheoesophageal fistula in 01(1.6%) patients

Conclusion: Elective tracheostomy in neck dissection patients is associated with a considerable risk of intraoperative and postoperative complications. However, most complications are manageable with timely and appropriate care. Continued refinement in surgical technique and postoperative protocols is essential to minimize these risks in this high-risk population.

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References

Vulcu Cordunianu A-G, Cordunianu MA, Cochior D. Elective vs. emergency tracheotomy complications in advanced hypopharyngeal cancer. Experimental and Exp Ther Med 2024; 28(4): 388. https://doi.org/10.3892/etm.2024.12677

2. Natasha N, Khurshied S, Zahid MA, Khurshid N, Hussain A, Khizer MA, et al. Comparison between complications of elective and emergency tracheostomies. Cureus 2023; 15(11): e48612.

https://doi.org/10.7759/cureus.48612

3. Katial T, Shree S, Mishra K, Mishra S, Mustajab MA, Gupta M et al. Comparison of percutaneous single-stage dilatational tracheostomy and surgical tracheostomy in critically ill patients: a randomized controlled trial. Int J Crit Illn Inj Sci 2024; 14(1): 9-14. https://doi.org/10.4103/ijciis.ijciis_53_23

4. Goh E, Loh N, Loh J. Submental intubation in oral and maxillofacial surgery: a systematic review 1986–2018. Brit J Oral Maxillofac Surg 2020; 58(1): 43-50.

https://doi.org/10.1016/j.bjoms.2019.10.314

5. Selekwa M, Maina I, Yeh T, Nkya A, Ncogoza I, Nuss RC, et al. Tracheostomy care quality improvement in low-and middle-income countries: A scoping review. PLOS Glob Public Health 2023; 3(11): e0002294.

https://doi.org/10.1371/journal.pgph.0002294

6. Mukherjee S, Jain A, Waindeskar V. Clinical outcome of perioperative airway and ventilatory management in patients undergoing surgery for oral cavity cancer: a prospective observational study. J Korean Assoc Oral Maxillofac Surg 2024; 50(3): 146-52. https://doi.org/10.5125/jkaoms.2024.50.3.146

7. Gaware SG, Babu MS. A Surgical Audit of Tracheostomy. Indian J Otolaryngol Head Neck Surg 2024; 76(2): 1491-1497.

https://doi.org/10.1007/s12070-023-04308-w

8. Jin YJ, Han SY, Park B, Park IS, Kim JH, Choi HG et al. Mortality and cause of death in patients with tracheostomy: Longitudinal follow‐up study using a national sample cohort. Head Neck 2021; 43(1): 145-152. https://doi.org/10.1002/hed.26471

9. Khan T, Rashid A, Samee MA, Ali A. Comparison of Outcomes between Elective Tracheostomy versus Emergency Tracheostomy. Pak J Med Health Sci 2021; 15(7): 1560-1562.

https://doi.org/10.53350/pjmhs211571560

10. Romem A, Gilboa H. Percutaneous tracheostomy in the ICU: a review of the literature and recent updates. Curr Opin Pulm Med 2023; 29(1): 47-53.

https://doi.org/10.1097/MCP.0000000000000928

11. Natasha N, Khurshied S, Zahid MA, Khurshid N, Hussain A, Khizer MA, et al. Comparison between complications of elective and emergency tracheostomies. Cureus. 2023; 15(11): e48612.

https://doi.org/10.7759/cureus.48612

12. Hassan ZU, Akbar F, Maka TA. Short-term complications of emergency and elective tracheostomy; a comparative study. Life Sci 2021; 2(2): 5. https://doi.org/10.37185/LnS.1.1.117

13. Burjan O, Yurevich N, Kuchmiy YY, Zmeyev V. Evention of infectious complications of tracheostomy in patients with head and neck cancer pathology. Kharkiv Surg School 2022(4-5): 30-33. https://doi.org/10.37699/2308-7005.4-5.2022.06

14. Abril MK, Berkowitz DM, Chen Y, Waller LA, Martin GS, Kempker JA et al. The epidemiology of adult tracheostomy in the United States 2002–2017: a serial cross-sectional study. Crit Care Explor 2021; 3(9): e0523.

https://doi.org/10.1097/CCE.0000000000000523

15. Wasim MF, Riaz N, Aslam S, Asad Shabbir Bukhari SM, Mumtaz H, Ahmed W. Complications of tracheostomy and leading factors among patients presenting at a tertiary care hospital, karachi. Pak Armed Forces Med J 2021; 71(3): 775-778.

16. Khammas AH, Dawood MR, Hamad AK. Evaluation of early complications of open surgical tracheostomy. Mustansiriya Med J 2017; 16(2): 36-42.

17. Lubianca Neto JF, Castagno OC, Schuster AK. Complicações de traqueostomia em crianças: uma revisão sistemática. Brazilian J Otorhinolaryngol 2022; 88: 882-890.

https://doi.org/10.1016/j.bjorlp.2022.09.010

18. Zouk AN, Batra H. Managing complications of percutaneous tracheostomy and gastrostomy. J Thorac Dis 2021; 13(8): 5314.

https://doi.org/10.21037/jtd-19-3716

19. Ranjan AA, Kumar PP, Shivappa SK, Ahmed M, Basavaraja GV. Indications and outcome of tracheostomy in a pediatric intensive care unit: A prospective observational study. J Pediatric Crit Care 2021; 8(4): 182-185.

https://doi.org/10.4103/jpcc.jpcc_173_20

20. Spataro E, Durakovic N, Kallogjeri D, Nussenbaum B. Complications and 30‐day hospital readmission rates of patients undergoing tracheostomy: a prospective analysis. Laryngoscope 2017; 127(12): 2746-2753. https://doi.org/10.1002/lary.26668

21. Ruohoalho J, Xin G, Bäck L, Aro K, Tapiovaara L. Tracheostomy complications in otorhinolaryngology are rare despite the critical airway. Eur Arch OtoRhinoLaryngol 2021; 278(11)4519-4523. https://doi.org/10.1007/s00405-021-06707-7