Abstract
The purpose of this study was to determine the relationship of early and delayed tracheostomy
decannulation protocols on the length of stay, time to oral feeding and incidence
of postoperative complications in patients undergoing microvascular reconstruction
for oral cancer.
A review of all patients who underwent surgical management of oral squamous cell carcinoma
(OSCC) over the study period from 01/07/2017 to 31/06/2021 was performed. Patients
who underwent elective tracheostomy as part of their microvascular reconstruction
were included. Two cohorts were identified based on distinct postoperative tracheostomy
decannulation protocols; early (Within 7 days) and delayed (≥7 days). Time to oral
feeding, length of stay and complication rates was determined for both groups for
statistical analysis.
A total of 103 patients with OSCC were included in the study. The overall complication
rate was 35.9% and were more likely in node positive patients (53.7% vs 23.2%; p = 0.003) and in cases where the geniohyoid muscle complex was disrupted during tumour
resection (66.7% vs 31.9%; p = 0.026). Early decannulation was significantly associated with shorter length of
hospital stay (10 days vs 15 days) and earlier removal of nasogastric feeding tubes
(7 vs 10 days). There was no difference in the overall complication rate between the
two groups (33.3% vs 37.5%; p = 0.833).
Early decannulation in appropriately selected patients is recommended as it significantly
reduces the length of hospital stay and aids in early resumption of oral intake. Furthermore,
this approach is not associated with increased rates of complications.
Keywords
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Article info
Publication history
Published online: December 16, 2022
Accepted:
November 1,
2022
Identification
Copyright
© 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
