Tracheostomy in surgical practice: experience in a Nigerian tertiary hospital.

BACKGROUND

Tracheostomy continues to be a standard surgical procedure for airway management.

OBJECTIVE

This study was conducted to evaluate the indications, and complications associated with the utilization of open surgical tracheostomy in our center.

DESIGN AND

SETTING

It is a retrospective study of all patients that had open surgical tracheostomy at the Obafemi Awolowo University Teaching Hospital, Ile-Ife. Nigeria during a 15-year period between January 1986 and December 2000.

PATIENTS AND

METHODS

The medical records of the forty-four patients that had open surgical tracheostomy in the operating theatre within the study period were evaluated.

RESULTS

There were 12 females and 32 males. The mean age was 33.6 +/- 24.8 years. The indications for tracheostomy were trauma (n =15), infections (n = 13), laryngeal (benign and malignant) tumors (n = 9), other head and neck malignancies (n = 4), neurological cases with respiratory failure (n = 2), and tracheomalacia (n = 1). All the tracheostomies were performed as an emergency as all the patients presented in respiratory obstruction. Transverse incision was employed in n = 35 cases, while the longitudinal incision was employed in n = 3 and the type of incision was not specified in the remaining six cases. Laryngeal stenosis was found in 6.9% of cases and the mortality was 25%.

CONCLUSION

Upper airway obstruction was the major indication for tracheostomy in our center; and the high mortality may be due to the primary medical problems rather than the complications of tracheostomy alone.