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Comparison of criteria for elective tracheostomy in head and neck cancer surgery

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Kissin F., Rysz M., Budziszewska M., Krajewski R.
Polish Journal of Otolaryngology
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2021
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vol. 75
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issue 4
20-26
EN
Elective tracheostomy before resection of a malignancy in head and neck region assures unobstructed ventilation during postoperative period but is associated with an increased risk of complications. We aimed to evaluate retrospectively, how the application of elective tracheostomy scales would influence the frequency of tracheostomy in comparison with preoperative clinical judgement. In 205 patients operated on from 2013 till 2017, theresection of a malignancy involved suprahyoid or pharyngeal muscles, neck dissection and flap reconstruction. The decision on elective tracheostomy was made on the clinical basis. Score for each patient in 3 published scales was calculated. In the study group 76 patients had elective tracheostomy at the outset of a resection procedure. Among 129 patients without elective tracheostomy, 9 had tracheostomy in the postoperative period. Indications for elective tracheostomy were calculated for scale I, II and III. Only in 120 patients the decision whether to perform elective tracheostomy would be identical in each scale. Our results suggest that decisions to perform elective tracheostomy based on 3 scales show low specificity. The factors used in the published scales should be evaluated in a prospective multicenter study
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Methicillin Resistant Staphylococcus Aureus Infections of Soft Issues of the Oral Cavity, Face and Neck in Patients Hospitalized at the Cranio-maxillofacial Surgery Department

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Gaszyńska E., Tyndorf M., Manowska B., Arkuszewski P.
Polish Journal of Surgery
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2011
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vol. 83
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issue 4
212-215
EN
The aim of the study was to identify a group of patients at high risk of methicillin resistant Staphylococcus aureus (MRSA) infection following surgical procedures involving oral cavity, head and neck.Material and methods. A retrospective analysis of demographic, clinical and laboratory data was performed. A manual search of laboratory records for a five years period (2005-2009) was performed for specimens submitted to the diagnostic microbiology laboratory from patients admitted to the Cranio-Maxillofacial and Oncologic Surgery Department.Results. Methicillin resistant Staphylococcus aureus was identified in 26 cases. Most commonly it was isolated from tongue swabs in patients following extensive oncological surgical procedures involving oral cavity. Most common risk factors were: age above 65 years, neoplasms, multisite trauma with loss of consciousness, cigarette smoking, alcohol abuse, tobacco addiction, antibiotic therapy immediately before hospitalization. More than half of patients with MRSA infection required surgical treatment except for pharmacological treatment.Conclusions. Monitoring of postoperative wounds is of great importance with regard to he risk of MRSA infection.
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