Utilization of Tracheostomy in Craniomaxillofacial Trauma at a Level-1 Trauma Center

Holmgren, Eric P.; Bagheri, Shahrokh C.; Bell, R. Bryan; Bobek, Samuel L.; Dierks, Eric J.

doi:10.1016/j.joms.2007.05.019

Cited by 43 publications

(14 citation statements)

References 18 publications

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“…It is generally recommended that tracheotomy should be performed early in the course of disease to accentuate its benefits [13,14]. In the present study, patients on mechanical ventilation were referred for tracheotomy after a threshold of 10 days.…”

Section: Discussionmentioning

confidence: 94%

Tracheotomy in Cancer Patients: Experience from a Cancer Hospital in Pakistan

et al. 2014

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Tracheotomy is commonly performed for the management of upper airway compromise. Trauma and head and neck cancers are the most frequent indications. The objective of this study was to share our experience with tracheotomy performed for a broad range of malignancies including but not limited to head and neck cancer. This study is a retrospective case series of patients who underwent tracheotomy from January 2004 to June 2012 at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. A total of 130 patients were included in the study. Patient demographics, indications for tracheotomy, underlying malignancy, and duration of follow-up were assessed. Main indications were elective (prolonged intubation and/or as a prerequisite for head and neck cancer surgery) and emergency (stridor). Outcome was assessed on a basis of successful decannulation and complications related to tracheotomy. Indications for tracheotomy were elective in 55 (44.7 %) and emergent in 75 (55.3 %) patients. Most common underlying malignancy was leukemia/lymphoma in 38 (29.2 %) patients. There were seven (5.3 %) complications in emergency tracheotomies including bleeding in three, emphysema in two, and dislodgement and infection in one patient each. In the elective setting, three (2.3 %) complications were observed with dislodgement in one and stomal stenosis in two patients. Decannulation was successfully carried out in 23 (18 %) patients. Median followup of patients was 1 month (range 0-86). No tracheotomyrelated mortality was observed. Tracheotomy was performed with relative safety in cancer patients, but low rate of successful decannulation predominantly due to persistent nature of disease.

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Section: Discussionmentioning

confidence: 94%

Tracheotomy in Cancer Patients: Experience from a Cancer Hospital in Pakistan

et al. 2014

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“…One study found that tracheostomy was required in 22.4% of all Le Fort fracture patients and 43.5% of Le Fort III fracture patients [11]. The need for tracheostomy has been associated with poorer outcomes as the mortality rate for patients that did not require tracheostomy was 0%, while the mortality rate for those requiring tracheostomy was 7.2% [30]. Tracheostomy can often be avoided through utilization of fiber optic intubation techniques.…”

Section: Managementmentioning

confidence: 99%

Le Fort Fractures: A Collective Review

Phillips¹,

Turco²

2017

BEAT

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Le Fort fractures constitute a pattern of complex facial injury that occurs secondary to blunt facial trauma. The most common mechanisms of injury for these fractures, which are frequently associated with drug and alcohol use, include motor vehicle collisions, assault, and falls. A thorough search of the world's literature following PRISMA guidelines was conducted through PubMed and EBSCO databases. Search terms included "Le Fort fracture", "facial", "craniofacial", and "intracranial." Articles were selected based on relevance and examined regarding etiology, epidemiology, diagnosis, treatment, complications, and outcomes in adults. The analyzed studies were published between 1980 and 2016. Initial data search yielded 186 results. The search was narrowed to exclude articles lacking in specificity for Le Fort fractures. Fifty-one articles were selected, the majority of which were large case studies, and collectively reported that Le Fort fractures are most commonly due to highvelocity MVC and that the severity of fracture type sustained occurred with increasing frequency. It was also found that there is a general lack of published Level I, Level II, and Level III studies regarding Le Fort fracture management, surgical management, and outcomes. The limitation of this study, similar to all PRISMA-guided review articles, is the dependence on previously published research and availability of references as outlined in our methodology. While mortality rates for Le Fort fractures are low, these complex injuries seldom occur in isolation and are associated with other severe injuries to the head and neck. Quick and accurate diagnosis of Le Fort fractures and associated injuries is crucial to the successful management of blunt head trauma.

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“…Holmgren has emphasised that open tracheostomy is the safest way to stabilise the airway,1 but there are also several methods of percutaneous dilatational tracheostomy that cause less damage to the surrounding tissues 2. The disadvantages of percutaneous dilatational tracheostomy are a lack of a clear view of the tissues and the difficulty of surgical intervention in case of severe bleeding.…”

Section: Discussionmentioning

confidence: 99%