Endoscopically monitored percutaneous dilational tracheotomy in a residency program.
OBJECTIVE
Endoscopically guided percutaneous dilational tracheotomy (PDT) has become a well-established alternative to the more traditional open tracheotomy, yet its use by otolaryngologists is limited. As airway management specialists, otolaryngologists should be familiar with a wide range of definitive procedures, including PDT. Few otolaryngology programs teach the technique. The objective of the present study was to determine the complication rate and outcome of PDT after its introduction in a residency teaching program. We also wished to evaluate whether the time savings reported by experienced surgeons could be repeated in our setting.


METHODS
Tertiary referral teaching hospital.


METHODS
We prospectively reviewed our first 54 consecutive PDTs and compared them to 29 consecutive standard open tracheotomies, which were reviewed retrospectively.


RESULTS
Complications (13% vs. 33%, P = .030), operative time (12 vs. 24 min, P < .0001) and total procedure time (37 vs. 80 min, P < .001) were significantly reduced in the PDT group as compared with standard tracheotomy. Initial outcome data were equal in both groups.


CONCLUSIONS
We found that PDT can be safely and effectively taught as part of an otolaryngology residency training program.
Donaldson
D R
DR
Department of Otolaryngology--Head and Neck Surgery, State University of New York at Buffalo, USA.
Emami
A J
AJ
Wax
M K
MK
D000368:Aged; D004106:Dilatation; D004493:Education; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010036:Otolaryngology / Q000193:education*; D011183:Postoperative Complications; D011446:Prospective Studies; D012867:Skin; D014140:Tracheotomy / Q000379:methods*