2024/07/10 by Oluleke, Omisakin Olatunde
#Tracheostomy #airway #indications #maxillofacial #surgery #techniques
paper · doi:10.60787/tnhj.v24i2.833
Background: Tracheostomy as a common surgical procedure in maxillofacial surgery is indicated in difficult intubation, severe orofacial infections, neoplasms, traumatic respiratory obstruction and congenital orofacial malformations. Study reviewed the indications and techniques used for tracheostomy in maxillofacial surgical patients in a teaching hospital. Method: This was a retrospective study of the clinical aspects, treatment methods, and clinical course of 54 patients who underwent tracheostomies by a consultant in the Dental/Maxillofacial Clinic of Barau Dikko Teaching Hospital, between January, 2010 and April, 2024. Data collected from the accident and emergency, theatre and outpatient clinic registers, included patient age, clinical diagnosis, indications for tracheostomy, surgical procedures performed and complications. Result: 54 patients had tracheostomy as elective and emergency surgeries during the period. Male to female ratio was 1.25: 1.00. Commonest indications was ankylosis of the temporomandibular joints (n=16, 29.63%), then massive tumors of the mandible (n= 12, 22.22%); panfacial fractures was the least (n=2, 3.70%). Elective surgeries (n=45, 83.33%) were the commonest interventions. Unilateral and bilateral condylectomies were the commonest procedures done (n=12, 22.22%). Intraoperative complications include bleeding and paratracheal placement of tube. Postoperative complications include blockage of tube with secretions and blood clot; subcutaneous surgical emphysema was significant in few patients after closure of the tracheostomy site. No patient had tracheal stenosis and the wound healed satisfactorily. Conclusion: The standardized surgical technique presented here reduces the associated surgical risk. Maxillofacial surgeons need to be proficient in tracheostomy. Good knowledge of anatomy of important structures and handling them correctly greatly reduces complications.