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Updated: May 23, 2026
05:39
Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
Adverse Airway Events Following Head and Neck Cancer Reconstruction Without Elective Tracheostomy
Ting-Chia Young1, Tsung-You Tsai2,3, Kai-Chieh Chan2,3
1Department of Medical Education, Chang Gung Memorial Hospital, Linkou, Taiwan.
Summary
Identifying predictors of adverse airway events (AAEs) in patients not undergoing elective tracheostomy (ET) is crucial. While ET may increase postoperative complications, understanding AAE risks helps guide selective use in airway management.
Area of Science:
- Otolaryngology
- Anesthesiology
- Surgical Oncology
Background:
- Elective tracheostomy (ET) is performed for various reasons, but risks of adverse airway events (AAEs) without ET are not well understood.
- Prior studies focused on ET decision-making, leaving a gap in knowledge regarding AAE predictors in non-ET patients and ET's postoperative impact.
Purpose of the Study:
- To identify predictors of AAEs in patients managed without ET.
- To evaluate postoperative outcomes associated with ET.
Main Methods:
- Systematic review and meta-analysis of 25 studies (N=5987) following PRISMA guidelines.
- Analysis of AAE predictors using pooled odds ratios (ORs).
- Evaluation of postoperative outcomes by converting pooled ORs into number needed to harm.
Main Results:
- Pooled AAE incidence in non-ET patients was 10.3%.
- Floor-of-mouth (OR, 5.96) and oropharyngeal tumors (OR, 2.60), bilateral neck dissection (OR, 6.36), and higher ASA class (OR, 1.51) predicted AAEs.
- ET correlated with increased flap complications (OR, 2.15), unplanned returns to OR (OR, 1.73), and delayed oral feeding (5.86 days).
Conclusions:
- Key predictors of AAEs were identified, enabling early risk recognition for selective ET in vulnerable patients.
- ET is associated with increased postoperative morbidity, necessitating selective use in perioperative airway planning.
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