The Journal of laryngology and otology · 2026
Clinical patterns, timing, and indications of surgical tracheostomy in non-laryngeal head and neck cancers: a retrospective tertiary centre experience.
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Erol Selçuk, Duran Arzubetül
Аннотация
OBJECTIVES: This study aimed to evaluate the indications, timing and mechanisms of surgical tracheostomy in non-laryngeal head and neck cancers.
METHODS: We retrospectively reviewed 29 patients who underwent tracheostomy between January 2020 and July 2022. Data included demographics, tumour site, treatment modality, timing, indications and airway pathology. Timing was classified as pre-treatment, during treatment, early (< 30 days) or late (> 30 days).
RESULTS: Nasopharynx was the most common subsite (n = 6; 20.7 per cent) and chemoradiotherapy the predominant treatment (n = 13; 44.8 per cent). Most tracheostomies occurred during or after treatment. At follow-up, 10 patients were decannulated and 19 remained dependent or intubated. Respiratory distress/desaturation was the leading indication (n = 15; 51.8 per cent). Median radiotherapy dose was 66 Gy. Timing reflected mechanism: acute causes occurred earlier, chronic causes later (p < 0.01).
CONCLUSION: Tracheostomy in non-laryngeal head and neck cancer is primarily driven by treatment-related airway changes. A timing- and mechanism-based approach may facilitate earlier risk stratification and reduce emergency airway interventions.
METHODS: We retrospectively reviewed 29 patients who underwent tracheostomy between January 2020 and July 2022. Data included demographics, tumour site, treatment modality, timing, indications and airway pathology. Timing was classified as pre-treatment, during treatment, early (< 30 days) or late (> 30 days).
RESULTS: Nasopharynx was the most common subsite (n = 6; 20.7 per cent) and chemoradiotherapy the predominant treatment (n = 13; 44.8 per cent). Most tracheostomies occurred during or after treatment. At follow-up, 10 patients were decannulated and 19 remained dependent or intubated. Respiratory distress/desaturation was the leading indication (n = 15; 51.8 per cent). Median radiotherapy dose was 66 Gy. Timing reflected mechanism: acute causes occurred earlier, chronic causes later (p < 0.01).
CONCLUSION: Tracheostomy in non-laryngeal head and neck cancer is primarily driven by treatment-related airway changes. A timing- and mechanism-based approach may facilitate earlier risk stratification and reduce emergency airway interventions.