Analysis of morbidity, mortality, and risk factors of tracheostomy-related complications in patients with oral and maxillofacial cancer

Abstract

BackgroundThis study aimed to analyze and describe the morbidity and mortality associated with tracheostomy in patients with oral cancer and to identify the risk factors associated with tracheostomy complications.MethodsWe performed a retrospective chart review of patients who underwent tracheostomy during a major oral cancer resection between March 2001 and January 2016 at the National Cancer Center, Korea. Overall, we included 51 patients who underwent tracheostomy after oral cancer surgery. We assessed the morbidity and mortality of tracheostomy and determined the risks associated with tracheostomy complications.ResultsTwenty-two tracheostomy-related complications occurred in 51 patients. The morbidity and mortality rates were 35.2 % (n = 18) and 0 % (n = 0), respectively. Tracheostomy-related complications were tracheitis (n = 4), obstructed tracheostomy (n = 9), displaced tracheostomy (n = 5), air leakage (n = 1), stomal dehiscence (n = 1), and decannulation failure (n = 2). Most complications (19/22) occurred during the early postoperative period. Considering the risk factors for tracheostomy complications, the type of tube used was associated with the occurrence of tracheitis (p < 0.05). Additionally, body mass index and smoking status were associated with tube displacement (p < 0.05). However, no risk factors were significantly associated with obstructed tracheostomy.ConclusionsPatients with risk factors for tracheostomy complications should be carefully observed during the early postoperative period by well-trained medical staff.

Cadaveric Bone Allografting for Severe Mandibular Hypoplasia With Alleviation of Upper Airway Obstruction in Goldenhar Syndrome

“…3,5 It appears that the popularity of immediate mandibular surgical intervention has increased with improved technologies such as mandibular distraction osteogenesis, and this likely relates to tracheostomy-related complications, which pose significant risk of morbidity and mortality. 4 Previous studies have demonstrated significant relief of upper airway obstruction following mandibular distraction osteogenesis for patients with mandibular hypoplasia at early intervention (2.5 months) 5 and at long-term follow up, but these cases require the presence of at least a portion of the ramus-condyle subunit, not present in our patient. 6 Bone allografts, particularly in the well-vascularized infant craniofacial skeleton, may offer particular promise for craniofacial reconstruction.…”

Tracheostomy complications in otorhinolaryngology are rare despite the critical airway

“…We report a total complication rate of 22%, which is less than some previous studies report, despite we recorded also medical complications. Lee et al [ 5 ] reported tracheostomy complication rate of 43% in patients with major oral cavity cancer resection. However, they did not report medical complications.…”

Prognostic impact of elective tracheotomy in resected oral cavity squamous cell carcinoma: A nationwide cohort study

“…The tracheotomy group exhibited a significantly higher prevalence of several variables compared to the non-tracheotomy group (all p values <0.0001). These factors included: (1) tumors located at the gum, mouth floor, retromolar subsites, (2) male sex, (3) pT3-4 disease, (4) pN2-3 disease, (5) p-Stage IV, (6) poorly differentiated tumor, (7) clear margins (≥5 mm), (8) deeper DOI, (9) reconstruction with free flap reconstruction, (10) treatment involving surgery and adjuvant therapy, (11) higher weighted Charlson comorbidity index (CCI), 19 and ( 12) prolonged hospital stays.…”

“…This strategy has led to tracheotomy rates that fluctuate between 14% 12 and 34%. 13 Although elective tracheotomy is associated with certain complications [7][8][9]11 and has been reported to influence survival rates, 10 some researchers have observed that surgeries for OCSCC, which often necessitate tracheotomy, do not typically lead to severe complications or significantly affect the overall outcomes. 9,11 Anecdotal evidence from our clinical practice suggests that tracheostomy may not have a substantial influence on the survival outcomes of patients with OCSCC.…”