A cartilage conserving concept of a surgical tracheostomy—introduction and analysis of safety and complications of the Visor-tracheostomy—a retrospective monocentric comparative study over 8 years

TY - JOUR

T1 - A cartilage conserving concept of a surgical tracheostomy—introduction and analysis of safety and complications of the Visor-tracheostomy—a retrospective monocentric comparative study over 8 years

AU - Fiedler, Lukas S.

AU - Kress, Peter

AU - Wang, Sophie

AU - Herbst, Manuel

PY - 2022/1

Y1 - 2022/1

N2 - IntroductionFor decades, surgical tracheostomy using a Bjoerk-flap has been the standard procedure to create a reliable epithelialized tracheostomy in head and neck tumour surgery. This technique is being used as the gold standard approach in every surgical subspecialty. Preparation of the Bjoerk-flap requires splitting one or two tracheal rings, causing potential tracheal instability and tissue trauma. As a surgical alternative, the Visor-tracheostomy allows creating an epithelialized tracheostomy without splitting tracheal rings. This work aimed to prove the safety of the Visor-tracheostomy method, due to peri- and early postoperative complications.MethodsWe present a step-by-step approach of this “new tracheostomy method”. Monocentric, retrospective data within 8 years were evaluated. Complications such as wound infection, tracheostoma bleeding, tracheostoma dehiscence, and via falsa in a total of 453 tracheostomies (161 Bjoerk-flap and 292 Visor-tracheostomies) were compared and the results were analysed descriptively.ResultsOur data did not reveal a statistically significant difference in risk for a complication between the two methods (Visor-tracheostomy vs. Bjoerk-flap; p = 0.60; OR = 1.26, 95%-CI 0.60–2.82). This supports the hypothesis that applying the new cartilage conserving Visor-tracheostomy does not result in a reduction of safety for the patient.ConclusionWe contend, that the Visor-tracheostomy has the potential to supersede other surgical tracheostomy techniques in some indications.

AB - IntroductionFor decades, surgical tracheostomy using a Bjoerk-flap has been the standard procedure to create a reliable epithelialized tracheostomy in head and neck tumour surgery. This technique is being used as the gold standard approach in every surgical subspecialty. Preparation of the Bjoerk-flap requires splitting one or two tracheal rings, causing potential tracheal instability and tissue trauma. As a surgical alternative, the Visor-tracheostomy allows creating an epithelialized tracheostomy without splitting tracheal rings. This work aimed to prove the safety of the Visor-tracheostomy method, due to peri- and early postoperative complications.MethodsWe present a step-by-step approach of this “new tracheostomy method”. Monocentric, retrospective data within 8 years were evaluated. Complications such as wound infection, tracheostoma bleeding, tracheostoma dehiscence, and via falsa in a total of 453 tracheostomies (161 Bjoerk-flap and 292 Visor-tracheostomies) were compared and the results were analysed descriptively.ResultsOur data did not reveal a statistically significant difference in risk for a complication between the two methods (Visor-tracheostomy vs. Bjoerk-flap; p = 0.60; OR = 1.26, 95%-CI 0.60–2.82). This supports the hypothesis that applying the new cartilage conserving Visor-tracheostomy does not result in a reduction of safety for the patient.ConclusionWe contend, that the Visor-tracheostomy has the potential to supersede other surgical tracheostomy techniques in some indications.

U2 - 10.1007/s00405-021-06802-9

DO - 10.1007/s00405-021-06802-9

M3 - SCORING: Journal article

VL - 279

SP - 449

EP - 456

JO - EUR ARCH OTO-RHINO-L

JF - EUR ARCH OTO-RHINO-L

SN - 0937-4477

ER -