Feasibility of Percutaneous Dilatational Tracheotomy in Head and Neck Cancer Surgery: A Preliminary Study

ObjectivePercutaneous dilational tracheostomy (PDT) is a technique that can place a tracheostomy tube safely without visually identifying the trachea. We evaluated its feasibility during head and neck cancer surgery.Summary of background dataPDT has many advantages, such as less bleeding, easier technique, and shorter procedural time.MethodsTwelve patients who underwent PDT during head and neck cancer surgery from September 2016 to March 2018 were enrolled, and their medical records were reviewed retrospectively. Medical records of another 12 patients who underwent conventional tracheostomy during head and neck cancer surgery were analyzed. PDT was performed using a Ciaglia Percutaneous Tracheostomy Set. The tracheostomy point was determined by palpation without the guidance of bronchoscopy or ultrasonography. Blood loss, procedural time, communication between the cervical wound and tracheostomy wound, and complications were compared between the PDT group and the conventional group.ResultsThe PDT group had less blood loss, a shorter procedural time, and a lower incidence of communication between the cervical and tracheostomy wound. There was 1 case of conversion to conventional tracheostomy due to wrong tracheal penetration in the PDT group.ConclusionsPDT is safe and effective as an adjunctive procedure during head and neck cancer surgery.