AB196. SOH24AB_217. Selective use of tracheostomy for airway management in oral cavity oncology patients decreases perioperative morbidity and hospital stay
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AB196. SOH24AB_217. Selective use of tracheostomy for airway management in oral cavity oncology patients decreases perioperative morbidity and hospital stay

Jennifer Kearns, Conor Bowe, Colm Murphy, John Edward O’Connell

National Oral and Maxillofacial Unit, St. James’ Hospital, Dublin, Ireland

Background: Tracheostomy is traditionally used for airway management in head and neck oncological surgery. This has associated morbidity and delayed post operative recovery. The development of enhanced recovery after surgery (ERAS) protocols encourages consideration of whether tracheostomy is an absolute requirement for all patients in this cohort. This study assesses the safety of selective use of tracheostomy in this group.

Methods: The maxillofacial head and neck oncology database was accessed, reviewing patterns of tracheostomy use in 141 consecutive patients between August 2021–September 2023. Variables recorded: patient demographics, histopathology, site, tumor, node, and metastasis (TNM) staging, medical history, smoking and alcohol consumption status, resection, neck dissection status (unilateral, bilateral, none), reconstruction, placement of planned or emergency tracheostomy, days with tracheostomy, intensive care unit (ICU) stay, total hospital stay.

Results: One hundred forty-one patients (84 male, 58 female) had maxillofacial oncology procedures between August 2021–September 2023. Mean age was 62.3 years (range: 19.9–89.21 years). Squamous cell carcinoma (SCC) was the most common histopathological subtype (85.8%). Forty-two (29.7%) patients had no neck dissection; 73 (51.7%) a unilateral neck dissection; 26 (18.4%) bilateral neck dissection. Sixty (56%) patients had free flap reconstruction. Thirty-nine (27.6%) patients had tracheostomies. Two were unplanned tracheostomies. Only 31 of 60 patients who had a free flap had a tracheostomy.

Conclusions: The routine use of tracheostomy for airway management in patients undergoing surgical management of oral cavity malignancy is not required. This includes patients requiring free flap reconstruction. Appropriate patient selection is required. Avoidance of tracheostomy in this cohort reduces morbidity and decreases both ICU and total hospital stay.

Keywords: Oral cavity cancer; head and neck oncology; tracheostomy; length of stay; enhanced recovery after surgery (ERAS)

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab196
Cite this abstract as: Kearns J, Bowe C, Murphy C, O’Connell JE. AB196. SOH24AB_217. Selective use of tracheostomy for airway management in oral cavity oncology patients decreases perioperative morbidity and hospital stay. Mesentery Peritoneum 2024;8:AB196.

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