Tracheostomy in surgical practice: experience in a Nigerian tertiary hospital

Abstract

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.