title: The utility of chest radiography following percutaneous dilational tracheotomy.
abstract: OBJECTIVE
  To determine the need for routine chest radiography following percutaneous dilational tracheotomy (PDT).
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Tertiary care academic medical center.
  
  
  METHODS
  The records of 119 patients undergoing PDT between 1993 and 2000 for indications of prolonged intubation or need for pulmonary toilet. All patients received a portable chest radiograph immediately following the procedure.
  
  
  METHODS
  Incidence of postoperative pneumothorax or pneumomediastinum.
  
  
  RESULTS
  One patient (0.8%) undergoing PDT experienced a postoperative pnuemothorax. This patient was noted to have respiratory distress within 10 minutes following the procedure, suggesting a pneumothorax. A postoperative chest radiograph confirmed the clinical impression. No asymptomatic patients were diagnosed as having a pnuemothorax or pneumomediastinum using postoperative chest radiography.
  
  
  CONCLUSIONS
  Chest radiography following PDT is indicated when there are clinical findings suggesting pneumothorax or pneumomediastinum. Without clinical signs or symptoms, routine use of postoperative chest radiographs are unnecessary and not cost-effective.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wayne State University, Detroit, Mich., USA.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Swanson
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Meleca
authors.forename: Joseph
authors.initials: J
authors.lastname: Bander
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stachler
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017046:Cost Savings; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008478:Mediastinal Emphysema / Q000000981:diagnostic imaging* / Q000209:etiology; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011030:Pneumothorax / Q000000981:diagnostic imaging* / Q000209:etiology; D011184:Postoperative Period; D013902:Radiography, Thoracic / Q000191:economics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014140:Tracheotomy / Q000009:adverse effects* / Q000379:methods*; D019564:Unnecessary Procedures