Related Experiment Videos
'Defatting' tracheotomy in morbidly obese patients
Neil D Gross1, James I Cohen, Peter E Andersen
1Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Sciences University, Portland 97201, USA.
The Laryngoscope
|November 20, 2002
Summary
Defatting tracheotomy, a cervical lipectomy technique, safely accommodates standard tracheostomy tubes in morbidly obese patients. This procedure has a high rate of minor infectious complications but is a preferred surgical option.
Area of Science:
- Otolaryngology
- Bariatric Surgery
- Surgical Techniques
Background:
- Standard tracheostomy tubes often present fit challenges in morbidly obese patients due to increased neck girth.
- Surgical options include modifying the tube or recontouring the neck.
Purpose of the Study:
- To evaluate the safety and morbidity of the "defatting" tracheotomy, a cervical lipectomy technique for morbidly obese patients.
- To determine the feasibility of using standard tracheostomy tubes after neck recontouring.
Main Methods:
- Retrospective cohort study of 23 patients undergoing cervical lipectomy and tracheotomy between 1994 and 2001.
- Chart review for indications, demographics, body mass index, complications, and decannulation outcomes.
Main Results:
- The study included patients with a mean BMI of 55.9, primarily for respiratory failure (70%) or obstructive sleep apnea (30%).
- Overall tracheotomy-related complication rate was 43%, with wound infections and neck abscesses being common.
- Late complications occurred in 22% of patients, and 44% were ultimately decannulated.
Conclusions:
- Defatting tracheotomy is a safe and preferred surgical approach for placing standard tracheostomy tubes in morbidly obese individuals.
- The procedure is associated with a high incidence of minor infectious complications.
- Cervical lipectomy with tracheostomy offers a viable solution for airway management in this patient population.