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. 2023 Apr;43(2):99-107.
doi: 10.14639/0392-100X-N2192.

Thyroid-split tracheostomy: short- and long-term outcomes

Nir Tsur #  1   2 , Ella Segal #  1   2 , Eyal Yosefof  1   2 , Noam Koch  1 , Idan Zeeman  1   2 , Ella Reifen  1   2 , Ory Wiesel  3 , Gideon Bachar  1   2 , Esmat Najjar  1   2
Affiliations

Thyroid-split tracheostomy: short- and long-term outcomes

Nir Tsur et al. Acta Otorhinolaryngol Ital. 2023 Apr.

Abstract
in English, Italian

Objective: Compare long-term outcomes of thyroid-split and standard thyroid-retraction tracheostomy in a large cohort.

Methods: The healthcare database of a university-affiliated hospital was searched for past patients over 18 years of age from all of the hospital's wards on whom an ear, nose, and throat specialist performed a tracheostomy in the operating room between 2010 and 2020. Clinical data were extracted from the hospital and outpatient medical records. Life-threatening and non-life-threatening intra-operative and early and late post-operative adverse events in patients who underwent split-thyroid tracheostomy were compared with those who underwent standard tracheostomy.

Results: There was no significant difference in intra-operative and early post-operative complications, hospitalisation length, or early reoperation and death rates between the 140 (28%) thyroid-split tracheostomy patients and the 354 (72%) standard tracheostomy patients, although the thyroid-split group had more non-decannulated patients and a longer operative time.

Conclusions: Thyroid-split tracheostomy is safe and feasible. Compared to the standard procedure, it provides better exposure and a similar rate of complications, although its de-cannulation success rate is lower.

Tracheotomia con istmectomia tiroidea: risultati a breve e lungo termine.

Obiettivo: Analisi delle complicanze in un’ampia coorte di pazienti sottoposti a tracheotomia chirurgica con e senza istmotomia tiroidea.

Metodi: Un apposito database retrospettivo è stato completato, includendo tutti i pazienti maggiorenni sottoposti a tracheotomia chirurgica presso il nostro ospedale universitario nel periodo tra il 2010 e il 2020. È stata condotta un’analisi comparativa degli eventi avversi precoci, tardivi, mortali e non, insorti tra i pazienti sottoposti a tracheotomia con e senza istmotomia tiroidea.

Risultati: Non è stata riscontrata alcuna differenza statisticamente significativa in merito a complicanze intra-operatorie, post-operatorie precoci e tardive, tempo di ospedalizzazione e tasso di decessi tra i 140 pazienti (28%) sottoposti a tracheotomia con istmotomia tiroidea e i 354 (72%) sottoposti a tracheostomia senza istmotomia. Nella prima coorte di pazienti sono stati riscontrati un tempo operatorio maggiore e un maggior tasso di pazienti non decannulati.

Conclusioni: La tracheotomia con istmotomia tiroidea si conferma una tecnica sicura. Se paragonata alla tracheotomia senza istmotomia, permette una esposizione migliore dell’asse tracheale e un tasso di complicanze sovrapponibile, nonostante il riscontro di un minore tasso di decannulazione.

Keywords: complications; decannulation; thyroid split; tracheostomy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
7-day survival (Kaplan-Meier).
Figure 2.
Figure 2.
Thyroid split tracheostomy technique showing (A) before the thyroid split and (B) after the thyroid split, exposing the trachea above and below the cartilage window location (From De Leyn, et al., 2007, mod. Prof. Dr. P. De Leyn has permitted the author to use the figure in date January 20, 2023) .
See this image and copyright information in PMC

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