Two abstracts presented at the 2007 Combined Otolaryngology Spring Meeting (COSM) reflect where the news lies with the subject of tracheotomy: raising the index for suspicion for tracheal stenosis following percutaneous tracheotomy1 and better educating non-otolaryngologists who manage tracheotomy patients.2
Explore this issue:November 2007
Potential for Complications
In many medical institutions, percutaneous tracheotomy (PCT) techniques have become popular because of the advantages of this technique over open tracheotomy, which include cost effectiveness, safety, and ease and speed of performance. The use of PCT at the patient’s bedside means decreasing the need to transport a very ill patient to the operating theater. Studies comparing open tracheotomy and PCT have not shown a significant difference in morbidity and mortality between the two procedures. Closer attention to the duration of tracheotomy tube placement and the size of tracheotomy tubes has reduced rates of long-term sequelae. However the potential for the development of tracheal stenosis, a dangerous complication, requires a more careful look, said otolaryngologists at Thomas Jefferson University Hospital in Philadelphia.
“This institution has long history of dealing with tracheal stenosis,” said Maurits Boon, MD, an attending physician at Thomas Jefferson. Louis H. Clerf, MD, who was one of the founders of otolaryngology and a professor at Jefferson Medical College, was instrumental in recognizing some of the complications that occur with high tracheotomy and describing how the technique should be performed.