This study illustrates that otolaryngologists at our institution are performing fewer tracheotomies over time. If this trend continues, the experience of our trainees may become diluted through reduction in surgical volume. While multi-institutional studies are warranted, this review provides a summary of data collected at a tertiary care institution, which may reflect national trends.

Objectives: (1) Determine the trend of the number of tracheotomies performed by otolaryngologists. (2) Determine the changes in surgical technique over time. Methods: A retrospective chart review of all patients undergoing tracheotomy between 1999 and 2013 was performed at a large tertiary care hospital. Data were gathered from billing and operative reports to determine the specialty service performing the tracheotomy. Additionally, the surgical technique and indication for surgery were recorded. Negative binomial regressions (extension of Poisson regression to account for over dispersion) were conducted to examine number of tracheotomies for each specialty as function of year. Results: In 1999, 46.55% of tracheotomies were being performed by the otolaryngology service, compared with only 28% in 2013. This is a decline of 21.55% over time. Since 1999, general surgery has a steady increase in number of tracheotomies performed in comparison to the steady decrease performed by otolaryngology. Since 2008 general surgeons have significantly increased the number of percutaneous tracheotomies they perform (76%/year). Over the same period, the number of tracheostomies performed by the cardiothoracic (CT) surgery service has steadily increased by 26% per year. Most of the tracheotomies performed by CT surgery are percutaneous tracheotomies. Conclusions: This study illustrates that otolaryngologists in our institution are performing fewer tracheotomies over time. If this trend continues, the experience of our trainees may become diluted through reduction in surgical volume. While multi-institutional studies are warranted, this review provides a summary of the trend at a tertiary care institution which may well reflect national trends.