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Airway Management Strategy Using Seldinger Minitracheostomy Kit to Prevent Airway Obstruction after Oral Cancer
Kyotaro Koshika1, Keikoku Tachibana2, Tatsuki Hoshino2
1Department of Dental Anesthesiology, Tokyo Dental College.
The Bulletin of Tokyo Dental College
|November 15, 2021
Summary
Preventive minitracheostomy (MTS) after oral cancer surgery safely reduces airway obstruction and the need for tracheostomy. This airway management strategy offers a beneficial option for at-risk patients.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Anesthesiology
Background:
- Postoperative airway obstruction is a risk for patients undergoing oral cancer surgery.
- Traditional airway management may involve tracheostomy, a more invasive procedure.
Purpose of the Study:
- To evaluate the outcomes of using a preventive minitracheostomy (MTS) for airway management.
- To assess the safety and efficacy of MTS in reducing tracheostomy rates and airway obstruction post-oral cancer surgery.
Main Methods:
- A retrospective study of 105 patients who underwent MTS after oral cancer surgery (Oct 2014 - Mar 2020).
- Data collected included MTS procedure time, cannula duration, and complications.
- Comparison of tracheostomy and extubation rates before (Apr 2009 - Sep 2014) and after (Oct 2014 - Mar 2020) MTS implementation.
Main Results:
- MTS procedure time averaged 3.2 minutes with minor complications in 5 patients.
- Median tracheal cannula placement was 2 days.
- Post-MTS implementation, tracheostomy rates decreased from 32% to 21%, while MTS was used in 18% of cases.
Conclusions:
- Minitracheostomy is a safe and effective procedure for preventing airway obstruction after oral cancer surgery.
- MTS significantly reduces the requirement for formal tracheostomy.
- This airway management strategy improves patient outcomes by mitigating risks associated with airway obstruction.
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