gms | German Medical Science

78th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

16.05. - 20.05.2007, Munich

Is the conventional surgical tracheotomy with Björk-flap still contemporary?

Meeting Abstract

  • corresponding author Anja Kallert - University of Rostock, Rostock, Germany
  • Burkhard Kramp - University of Rostock, Rostock, Germany
  • Steffen Dommerich - University of Rostock, Rostock, Germany
  • Hans Wilhelm Pau - University of Rostock, Rostock, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 78th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Munich, 16.-20.05.2007. Düsseldorf, Köln: German Medical Science; 2007. Doc07hno044

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2007/07hno044.shtml

Published: August 8, 2007

© 2007 Kallert et al.
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Outline

Text

Today the percutaneous tracheotomy becomes more and more important, especially for emergency and intensive care units.

In that retrospective study all patients were analysed at the department of ENT of the University of Rostock who were undergoing a surgical tracheotomy in the period of 2000-2005. Tracheotomy was performed successfully in 490 patients, 221 patients with ENT-diseases and 269 patients for other departments like intensive care units of anesthesiology and neurology, also a department for rehabilitation. It included 343 men and 147 women. The numbers of tracheotomy for other clinics increased in that period.

In that study typical ENT-indications for an operative tracheotomy with a Björk-flap were stenosises in the upper airways caused by tumors, inflammations or traumas. Other indications were aspiration, revision of a percutaneous tracheotomy, paralysis of the swallowing process, bothsided vocal cord paralysis with inspiratoric stridor und congenital disorders in the respiratory tract. The main indication of the operation in intensive care units was long-term intubation.

Postoperative complications occured as peristomal granulations (46/490), dysphagia (46/490), minor inflammations (18/490), bleeding by the tracheostomy (15/490), tracheal stenosis (4/490), pneumothorax (2/490). All of them were treated with less complications.

The intension of our study was not to favour the conventional surgical or percutaneous tracheotomy, because each one has got its special indications. The advantages of the surgical tracheotomy are the safe changing of tracheal cannula, minor postoperative complications. Yet there are also disadvantages for example a potential second operation to occlude the tracheotomy after removing the cannula.

The aim of our study is to emphasise the necessity of discussions between the different departments to find the best treatment for the patient. All in all we can say the surgical tracheotomy with Björk-flap is essential in long-term treatment and rehabilitation.