[Long-term results after surgical tracheotomy and percutaneous dilatation tracheostomy. A comparative retrospective...

Besides surgical tracheostoma for treatment of long-term intubation, percutaneous dilatational tracheostomy (PDT) has become available during the last few years. Long-term results of the PDT are rare in the medical literature. This paper reports a retrospective analysis comparing the results after PDT with those after surgical tracheostomy. The methods include subjective evaluation of both techniques by the patients using a standardized questionnaire. It also includes the objective cosmetic result of the outside scar, as well as endoscopic inspection of the larynx and trachea. The patients own evaluation showed a higher content in the PDT group mainly due to the cosmetic result. The objective data confirmed those results. Patients with surgical tracheostomy had an average scar length of 5 cm (2 inches), compared to 1,2 cm (5 inch) in the PDT group. The endoscopic examination showed minor stenosis of the trachea in both groups that were not functionally relevant. The average stenosis of 14% for the PDT was similar to that observed after surgical tracheostomy which was 19%. The choice of the best technique should be made in close cooperation between head- and neck surgeons and anesthesiologists.