Selective use of tracheostomy in surgery for head and neck cancer: an audit

This retrospective study was designed to define the role of tracheostomy in the operative treatment of patients with cancers of the head and neck. The subjects were 51 patients who underwent neck dissection with resection of the tumour and repair during the period January 1992-December 1994, out of a total of 109 patients who were treated for cancers of the head and neck during that time. Three patients required tracheostomies, two of which were done preoperatively, and one immediately postoperatively for respiratory distress. There were no operative deaths. Morbidity included wound infection (n = 2), chest infection caused by Haemophilus influenzae (n = 1), transient fever associated with blood transfusion (n = 5), and transient fever of no obvious cause (n = 3). Median hospital stay was 10 days (range 4-38). Patients undergoing operations for cancers of the head and neck do not require routine tracheostomy. Further research on how to select patients who will need tracheostomy is necessary and is being done.