Publication:

A study on tracheostomy

Background Last two decades tracheostomy is assumed its rightful place as a safe simple procedure with a wide range of usefulness. Laryngeal obstruction became recognized as the chief indication for tracheostomy. Now a day, this is performed in head and chest injuries and other conditions where in normal respiratory efficiency is impaired. The present study was done to analyze the various indications and study the prevalence of tracheostomy and compare it between emergency and planned tracheostomy.

Methods This study includes patients who are intubated, that are referred from ICU with prolonged ventilation and those admitted into ENT ward with various indications. In this institute tracheostomy is done between 5th and 10th day for patients on mechanical ventilation.

Results Out of 80 total tracheostomies horizontal procedure done in 42 cases and 38 cases are vertical procedures. Horizontal procedure has more advantages than vertical procedure. Among 80 total procedures 48 cases are done under general anaesthesia and 32 cases under local anaesthesia. Most of the cases are elective done under general anaesthesia because patients are already intubated. Out of 80 cases 5 cases developed sudden apnea, 5 cases developed haemorrhage, 6 cases developed surgical emphysema and subglottic stenosis is developed in 1 case.

Conclusions It is evident from this study that prolonged mechanical ventilation is more common indication for tracheostomy. Majority of the tracheostomies are done in malignant conditions either carcinoma larynx or carcinoma hypopharynx with stridor and dyspnoea. This indicates not only the prevalence of malignancy in this region but also the dreaded ness of this disease causing air way.