An experience of 31 Tracheostomies, performed at Saidu Teaching Hospital

Abstract

Study design: Observational descriptive. Duration and place of study: March 2003 to December 2008 at Saidu Teaching Hospital Saidu Sharif Swat. Material and methods: Relevant details of all the patients, who underwent tracheostomy from March 2003 to December 2008, were recorded on a pre-designed proforma for each patient separately. Name, age, sex, indications, complications, time of decanulation and followup were noted. Tracheostomies were performed both in emergency as well as electively, under general or local anesthesia. All the procedures were carried out in the operation theater of Saidu Teaching Hospital, using standard technique. An electric suction machine and tracheostomy trolley were provided on bedside. Decanulation was carried out from 05 days to 01 month depending upon the etiology and satisfactory management of the airway obstruction. The patients were kept under observation for 24 hours after decanulation and afterwards, sent home with tight dressing over the wound. Attendants were educated about the wound care, allowing stoma to heal by secondary intension. Follow up was done after 10 to 15 days at the beginning and monthly for 06 months to one year later on. Results: A total of 31 patients, in the age group of 01 to 70 years, underwent tracheostomy. Two age peaks were noted below 10 years and above 25 years. The indications for emergency tracheostomy were mainly airway obstruction due to infectious diseases 09 (29%), neck trauma compromising airway 09 (29%) and foreign body laryngotracheobronchial tree 03 (9.6%), thyroid carcinoma 02 (6.4%), carcinoma larynx 01 (3.2%), metastatic nasopharyngeal carcinoma 01 (3.2%) and lymphoma 01 (3.2%). Where as for elective tracheastomies Nasopharyngeal Angiofibromas excision 03 (9.6%) was considered as indication. Overall our complications rate was 42.8%. 05 deaths were recorded due to terminal stage of the diseases and none directly related to tracheostomy. In 23 cases, decanulation was performed successfully. The time of decanulation ranged from 01 week to 04 weeks. 1st Follow up was done 10-15 days and then monthly for 01month to 01 year. 01 patient was still tracheostomized till the completion of the study. Two patients did not turn up.