Factors affecting selection of tracheostomy after mandibular tumor operation: a retrospective study

doi:10.19439/j.sjos.2020.03.020

Abstract

Abstract: PURPOSE: To assess the factors affecting selection of tracheostomy after mandibulectomy. METHODS: The clinical data of 165 patients who were divided into intubated group and tracheostomy group were collected from January 2008 to December 2012 in Shanghai Ninth People's Hospital, including demographics, smoke habits, alcohol consumption, pulmonary disease, American Society of Anesthesiologists (ASA) physical status classification, history of jaw operation, length of surgery, preoperative radiotherapy, free flap reconstruction, resection over the anterior midline, and radical neck dissection. The postoperative outcomes, such as the duration of keeping tube, the length of ICU stay, the length of hospital stay, and the number of complications and death were collected. Statistical analysis was performed using SAS version 9.2 software package. RESULTS: There were 81 patients in intubated group and 84 patients in tracheostomy group. Three factors that might be associated with selection of tracheostomy after mandibulectomy were preoperative radiotherapy (OR: 3.51, 95% CI: 1.34-9.20), free flap reconstruction (OR: 3.99, 95%CI: 1.84-8.65), and resection over the anterior midline of the jaw (OR: 20.08, 95%CI: 6.52-160.35)(P<0.05). CONCLUSIONS: Tracheostomy was suitable for patients who received preoperative radiotherapy, free flap reconstruction and resection over the anterior midline after mandibular tumor resection were factors in considering of tracheotomy.

Key words: Mandibular tumor, Tracheostomy, Mandibulectomy

CLC Number:

R782.05

JIN Li-hong, GU Zhen-hua, CHEN Zhi-feng, XU Hui. Factors affecting selection of tracheostomy after mandibular tumor operation: a retrospective study[J]. Shanghai Journal of Stomatology, 2020, 29(3): 329-332.

References

[1] Mochizuki Y, Omura K, Harada H, et al.Functional outcomes with dental prosthesis following simultaneous mandibulectomy and mandibular bone reconstruction[J]. J Prosthodont Res, 2014, 58(4): 259-266.
[2] Mustafa AA, Raad K, Mustafa NS.Effect of proper oral rehabilitation on general health of mandibulectomy patients[J]. Clin Case Rep, 2015, 3(11): 907-911.
[3] Hanasono MM, Zevallos JP, Skoracki RJ et al. A prospective analysis of bony versus soft-tissue reconstruction for posterior mandibular defects[J]. Plast Reconstr Surg, 2010, 125(5): 1413-1421.
[4] Lee YW, You HJ, Jung JA, et al.Mandibular reconstruction using customized three-dimensional titanium implant[J]. Arch Craniofac Surg, 2018,19(2):152-156.
[5] Mishra S, Bhatnagar S, Jha RR, et al.Airway management of patients undergoing oral cancer surgery: a retrospective study[J]. Eur J Anaesthesiol, 2005, 22(7): 510-514.
[6] Brickman DS, Reh DD, Schneider DS, et al.Airway management after maxillectomy with free flap reconstruction[J]. Head Neck, 2013, 35(8): 1061-1065.
[7] Crosher R, Baldie C, Mitchell R.Selective use of tracheostomy in surgery for head and neck cancer: an audit[J]. Br J Oral Maxillofac Surg, 1997, 35(1): 43-45.
[8] Rashid AO, Islam S.Percutaneous tracheostomy: a comprehensive review[J]. J Thorac Dis, 2017, 9(Suppl 10): S1128-S1138.
[9] Halum SL, Ting JY, Plowman EK, et al.A multi-institutional analysis of tracheotomy complications[J]. Laryngoscope, 2012, 122(1): 38-45.
[10] Marenzi G, Cosentino N, Werba JP, et al.A meta-analysis of randomized controlled trials on statins for the prevention of contrast-induced acute kidney injury in patients with and without acute coronary syndromes[J]. Int J Cardiol, 2015, 183: 47-53.
[11] Esteller E, Aguero A, Martel M, et al.Stomal recurrence in head and neck cancer patients with temporary tracheostomy[J]. Auris Nasus Larynx, 2014, 41(5): 467-470.
[12] Moubayed SP, Barker DA, Razfar A, et al.Microvascular reconstruction of segmental mandibular defects without tracheostomy[J]. Otolaryngoly Head Neck Surg, 2015, 152(2): 250-254.
[13] Gomez-Caro A, Gimferrer JM, Molins L.Lung incarceration after anterior mediastinal tracheostomy[J]. Ann Thorac Surg, 2013, 95(5): 1795-1797.
[14] Mohamedbhai H, Ali S, Dimasi I, et al.TRACHY score: a simple and effective guide to management of the airway in head and neck cancer[J]. Br J Oral Maxillofac Surg, 2018, 56(8): 709-714.
[15] Kheterpal S, Han R, Tremper KK, et al.Incidence and predictors of difficult and impossible mask ventilation[J]. Anesthesiology, 2006, 105(5): 885-891.
[16] Cavallone LF, Vannucci A.Review article: Extubation of the difficult airway and extubation failure[J]. Anesth Analg, 2013, 116(2): 368-383.
[17] Gupta K, Mandlik D, Patel D, et al.Clinical assessment scoring system for tracheostomy (CASST) criterion: Objective criteria to predict pre-operatively the need for a tracheostomy in head and neck malignancies[J]. J Craniomaxillofac Surg, 2016, 44(9): 1310-1313.
[18] Goettler CE, Fugo JR, Bard MR, et al.Predicting the need for early tracheostomy: a multifactorial analysis of 992 intubated trauma patients[J]. J Trauma, 2006, 60(5): 991-996.
[19] Kruse-Lösler B, Langer E, Reich A, et al.Score system for elective tracheotomy in major head and neck tumour surgery[J]. Acta Anaesthesiol Scand, 2005, 49(5): 654-659.
[20] Potter JK, Herford AS, Ellis E.Tracheotomy versus endotracheal intubation for airway management in deep neck space infections[J]. J Oral Maxillofac Surg, 2002, 60(4): 349-354.