A study on tracheostomy

Kuldeep Satna, Sunitha Bandaru


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.


Tracheostomy, Stridor, Dyspnoea, Malignancy

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Van Heurn LW, Brink PR. The history of percutaneous tracheostomy. J Laryngol Otol. 1996;110(8):723-6.

Peumery JJ. Armand Trousseau (1801-1867), French physician par excellence. Hist Sci Med. 2003;37(2):151-6.

Parcy P. Tracheostomy. In: Scott-Brown’s Otolaryngology, Head Neck Surg, eds.Michael Gleeson. 7th ed. Hodder Arnold; 2008: 2.

Bradley PJ. Management of the obstructed airway and Tracheostomy. In: Scott-Brown’s Otorhinolaryngology, Head Neck Surg. Watkinson JC, Clarke RW, eds. Head and Neck Surgery, Plastic Surgery. 6th ed. Butterworth-Heinemann; 1997.

Bailey BJ, Karen H. Calhoun. Tracheostomy and intubation. Head and Neck surgery, Otolaryngology. 3rd ed. NY: Lippincott; 2001;677(84):917-24.

Okhakhu AL, Emma-Nzekwue NH, Afolabi OA. Changing indications for paediatric tracheostomy in a Nigerian tertiary hospital. Port Harcourt Med J. 2012;6:264-8.

Eziyi JA, Amusa YB, Musa IO, Adeniji AO, Olarinoye OT, Ameye SA. Tracheostomy in south Western Nigeria: Any change in pattern? J Med Med Sci. 2011;2:997-1002.

Alabi BS, Ologe FE, Dunmade AD, Segun-Busari S, Olatoke F. Acute laryngeal obstruction in a Nigerian hospital: Clinical presentation and management. Niger Postgrad Med J. 2006;13(3):240-3.

Carron JD, Derkay CS, Strope GL, Nosonchuk JE, Darrow DH. Pediatric tracheostomies: changing indications and outcomes. Laryngoscope. 2000;110(7):1099-104.

Ang AH, Chua DY, Pang KP, Tan HK. Pediatric tracheotomies in an Asian population: the Singapore experience. Otolaryngol Head Neck Surg. 2005;133(2):246-50.

Ozmen S, Ozmen OA, Unal OF. Pediatric tracheotomies: a 37-year experience in 282 children. Int J Pediatr Otorhinolaryngol. 2009;73(7):959-61.

MacIntyre NR, Cook DJ, Ely EW, Epstein SK, Fink JB, Heffner JE, et al. Evidence based guidelines for weaning and discontinuing ventilator support. A collective task force facilitated by the American college of chest physicians, the American association for respiratory careand the American college of critical care medicine. Chest. 2001;120(6):375-95.

Soni NK, Chatterji MS, Thind SS. Tracheostomy in chindren. Indian J Pediatrics. 1984;51(408):45-7.

Mehta AK, Chamyal PC. Tracheostomy complications and their management. Med J Armed Forces India. 1993;55(3):197-200.

Goldenberg D, Ari EG, Golz A, Danino J, Netzer A, Joachims HZ. Tracheostomy complications: A retrospective study of 1130 cases. Otolaryngol Head Neck Surg. 2000;123(4):495-500.

Zeitouni AG, Kost KM. Tracheostomy: a retrospective review of 281 cases. J Otolaryngol. 1994;23(1):61-6.

Kluge S, Baumann HJ, Maier C, Klose H, Meyer A, Nierhaus A, et al. Tracheostomy in the intensive care unit: a nationwide survey. Anesth Analg. 2008;107(5):1639-43.

De Leyn P1, Bedert L, Delcroix M, Depuydt P, Lauwers G, Sokolov Y, et al.. Tracheotomy: clinical review and guidelines. Eur J Cardiothorac Surg. 2007;32(3):412-21.