A clinical study of tracheotomies in oral and maxillofacial surgery

At the Department of Oral and Maxillofacial Surgery, Yamaguchi University Hospital, 43 tracheotomies were performed between 1985 and 1994.Tracheotomies were classified as elective or emergency. Elective tracheotomies were performed in 37 cases (86.0%) and emergency tracheotomies in 6 cases (14.0%). The elective tracheotomies included 34 cases of oral cancer, 2 cases of multiple fractures of the jaws, and 1 case of benign tumor. Of these 34 cases of oral cancer, 17 underwent total or subtotal resection of maxilla, and 16 underwent immediate reconstruction with a pectoralis major myocutaneous flap after the resection of oral cancer.Six emergency tracheotomies were performed in patients with advanced oral cancer because of obstruction of the upper respiratory track or bleeding from the mouth or cervical region.The duration of intubation ranged from 3 to 214 days, with an average of 23.8 days. The tubes were used up to 10 days in 25 cases (58.1%).No serious complications occured during the operative or the early and late postoperative phases after tracheotomy.