Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-22T13:56:04.582Z Has data issue: false hasContentIssue false
  • English
  • Français

Single cannula versus double cannula tracheostomy tubes in major oral and oropharyngeal resections

Published online by Cambridge University Press:  28 December 2015

M Dhiwakar ,
G I Nambi ,
T V Ramanikanth ,
S M Kale  and
M N Sivakumar
M Dhiwakar*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Kovai Medical Center and Hospital, Coimbatore, India
G I Nambi
Affiliation:
Department of Plastic Surgery, Kovai Medical Center and Hospital, Coimbatore, India
T V Ramanikanth
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Kovai Medical Center and Hospital, Coimbatore, India
S M Kale
Affiliation:
Department of Plastic Surgery, Kovai Medical Center and Hospital, Coimbatore, India
M N Sivakumar
Affiliation:
Department of Intensive Care, Kovai Medical Center and Hospital, Coimbatore, India
*
Address for correspondence: Dr M Dhiwakar, Department of Otolaryngology – Head and Neck Surgery, Kovai Medical Center and Hospital, Avinashi Road, Coimbatore – 641 014, India Fax: +91 422 4323800 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To compare the outcomes of two types of tracheostomy tubes used in major head and neck surgery.

Methods:

A retrospective study was conducted of prospectively collected data. The post-operative safety and adequacy of a single cannula tracheostomy tube was compared to a double cannula tracheostomy tube in patients undergoing tracheostomy during major oral and oropharyngeal resections.

Results:

Out of 46 patients with the single cannula tube, 7 (15 per cent) experienced significant obstruction warranting immediate tube removal, while another 9 (20 per cent) needed a change of tube or tube re-insertion for continued airway protection. In contrast, out of 50 patients with the double cannula tube, the corresponding numbers were 0 (p = 0.004) and 1 (2 per cent; p = 0.007) respectively.

Conclusion:

Insertion of a double cannula (instead of a single cannula) tracheostomy tube in the course of major oral and oropharyngeal resections offers better airway protection during the post-operative period.

Keywords

TracheostomyNeckSurgeryComplicationsOral CancerSuction
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 4 , April 2016 , pp. 388 - 392
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Castling, B, Telfer, M, Avery, BS. Complications of tracheostomy in major head and neck cancer surgery: a retrospective study of 60 consecutive cases. Br J Oral Maxillofac Surg 1994;32:3–5Google Scholar
2Marsh, M, Elliott, S, Anand, R, Brennan, PA. Early postoperative care for free flap head and neck reconstructive surgery – a national survey of practice. Br J Oral Maxillofac Surg 2009;47:182–5CrossRefGoogle ScholarPubMed
3Mitchell, RB, Hussey, HM, Setzen, G, Jacobs, IN, Nussenbaum, B, Dawson, C et al. Clinical consensus statement: tracheostomy care. Otolaryngol Head Neck Surg 2013;148:6–20CrossRefGoogle ScholarPubMed
4Halfpenny, W, McGurk, M. Analysis of tracheostomy-associated morbidity after operations for head and neck cancer. Br J Oral Maxillofac Surg 2000;38:509–12CrossRefGoogle ScholarPubMed
5Leder, SB, Joe, JK, Ross, DA, Coelho, DH, Mendes, J. Presence of a tracheostomy tube and aspiration status in early, postsurgical head and neck cancer patients. Head Neck 2005;27:757–61CrossRefGoogle ScholarPubMed
6Salgarelli, AC, Collini, M, Bellini, P, Cappare, P. Tracheostomy in maxillofacial surgery: a simple and safe technique for residents in training. J Craniofac Surg 2011;22:243–6Google Scholar
7Malata, CM, Foo, IT, Simpson, KH, Batchelor, AG. An audit of Bjork flap tracheostomies in head and neck plastic surgery. Br J Oral Maxillofac Surg 1996;34:42–6CrossRefGoogle ScholarPubMed
8Sivakumar, K, Prepageran, N, Raman, R. Evaluation of tracheal diameter after surgical tracheostomy. Am J Otolaryngol 2006;27:310–13Google Scholar
9Mullins, JB, Templer, JW, Kong, J, Davis, WE, Hinson, J Jr. Airway resistance and work of breathing in tracheostomy tubes. Laryngoscope 1993;103:1367–72Google Scholar
10Clemens, MW, Hanson, SE, Rao, S, Truong, A, Liu, J, Yu, P. Rapid awakening protocol in complex head and neck reconstruction. Head Neck 2015;37:464–70CrossRefGoogle ScholarPubMed
11Arshad, H, Ozer, HG, Thatcher, A, Old, M, Ozer, E, Agarwal, A et al. Intensive care unit versus non-intensive care unit postoperative management of head and neck free flaps: comparative effectiveness and cost comparisons. Head Neck 2014;36:536–9CrossRefGoogle ScholarPubMed
12Burkle, CM, Walsh, MT, Pryor, SG, Kasperbauer, JL. Severe postextubation laryngeal obstruction: the role of prior neck dissection and radiation. Anesth Analg 2006;102:322–5CrossRefGoogle ScholarPubMed
13Sanguineti, G, Adapala, P, Endres, EJ, Brack, C, Fiorino, C, Sormani, MP et al. Dosimetric predictors of laryngeal edema. Int J Radiat Oncol Biol Phys 2007;68:741–9Google Scholar