[Factors affecting selection of tracheostomy after mandibular tumor operation: a retrospective study]

To assess the factors affecting selection of tracheostomy after mandibulectomy.

The clinical data of 165 patients who were divided into intubated group and tracheostomy group were collected from January 2008 to December 2012 in Shanghai Ninth People's Hospital, including demographics, smoke habits, alcohol consumption, pulmonary disease, American Society of Anesthesiologists (ASA) physical status classification, history of jaw operation, length of surgery, preoperative radiotherapy, free flap reconstruction, resection over the anterior midline, and radical neck dissection. The postoperative outcomes, such as the duration of keeping tube, the length of ICU stay, the length of hospital stay, and the number of complications and death were collected. Statistical analysis was performed using SAS version 9.2 software package.

There were 81 patients in intubated group and 84 patients in tracheostomy group. Three factors that might be associated with selection of tracheostomy after mandibulectomy were preoperative radiotherapy (OR: 3.51, 95% CI: 1.34-9.20), free flap reconstruction (OR: 3.99, 95%CI: 1.84-8.65), and resection over the anterior midline of the jaw (OR: 20.08, 95%CI: 6.52-160.35)(P<0.05).

Tracheostomy was suitable for patients who received preoperative radiotherapy, free flap reconstruction and resection over the anterior midline after mandibular tumor resection were factors in considering of tracheotomy.