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Indications for Elective Tracheostomy in Reconstructive Surgery in Patients With Oral Cancer
Yoav Leiser1, Michal Barak, Yasmine Ghantous
1*Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus †Bruce Rappaport Faculty of Medicine, Technion ‡Department of Anesthesiology, Rambam Health Care Campus, Haifa §Department of Maxillofacial Surgery, Baruch Padeh Medical Center, Poriya, The Faculty of Medicine, Bar Ilan University, Galilee ||Department of Otolaryngology Head and Neck Surgery, Bnai Zion Medical Center, Haifa, Israel.
Elective tracheostomy in oral cancer surgery is not always necessary. Selected patients, especially those with comorbidities or high-risk reconstructions, may benefit from this procedure to manage airway obstruction.
Area of Science:
- Oncology
- Head and Neck Surgery
- Anesthesiology
Background:
- Oral cancer surgery presents a significant risk of upper airway obstruction.
- Optimal airway management strategies following these procedures are debated.
Purpose of the Study:
- To evaluate the role of tracheostomy in patients undergoing oral cancer surgery with intraoral flap reconstruction.
Main Methods:
- A cohort of 75 patients with oral cancer who underwent major intraoral resections and vascularized flap reconstruction was studied.
- Patient data regarding tracheostomy use and outcomes were analyzed.
Main Results:
- 36% of patients (27) received an elective tracheostomy.
- Mean hospital stay was significantly longer for tracheostomy patients (28.4 days) compared to non-tracheostomy patients (9.7 days).
- A scoring system was developed, suggesting patients with a score of 8 or higher should be considered for elective tracheostomy.
Conclusions:
- Selected oral cancer patients can be managed postoperatively without routine tracheostomy with proper monitoring.
- Elective tracheostomy is recommended for elderly patients or those with comorbidities undergoing high-risk reconstructions that may compromise the airway.
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