Abstract
Tracheostomies performed on nineteen patients with terminal stage oral cancer in our department between April, 1996 and March, 2002 were clinically evaluated. The results were as follows:
1. Tracheostomies were performed on 14 (73.7%) males and 5 (26.3%) females. The mean age of the patients was 67.1 years, ranging from 19 to 90 years. Recurrence sites were: the cervical region in 12 cases and oral or oro-cervical regions in seven cases.
2. Tracheostomies were performed on 12 cases (11 cases with local anesthesia and 1 case with combination of local anesthesia and intravenous sedation with a minor tranquilizer) in the ward or the treatment room and 7 cases (3 cases with local anesthesia, 4 cases with general anesthesia) in the central operation room.
3. The criteria for indication of tracheostomy were: difficulty in expectoration of sputum in nine cases, upper airway obstruction in nine cases and one case for management of homeostasis.
4. As for pre-operative cervical findings for all the cases revealed that the trachea was palpable in 18 cases (94.7%) and the cervical extension was possible in 14 cases (73.7%). There was one case of respiratory arrest and one case of acute airway obstruction as an intra-operative incident (episode) encountered, in spite of all the precautions exercised. Conclusively, we postulated that pre-operative findings of the cervical region are important factors in deciding the timing of surgery and for the avoidance of intra- and post-operative complications.
