title: Indications for Elective Tracheostomy in Reconstructive Surgery in Patients With Oral Cancer.
abstract: BACKGROUND
  Oral cancer surgery carries a high risk of upper airway obstruction; yet optimal airway management approach remains controversial.
  
  
  OBJECTIVE
  The purpose of the present study was to evaluate the use of tracheostomy in oncological patients undergoing oral cancer surgery with intra oral flap reconstruction.
  
  
  METHODS
  The study cohort included 75 patients with oral cancer, who underwent major intraoral resections and reconstruction with vascularized flaps.
  
  
  RESULTS
  Thirty-six percent of the patients received elective tracheostomy (27 patients). Mean hospital stay of the patients with tracheostomy was 28.4 ± 12.5 days compared with 9.7 ± 2.1 days in the nontracheostomy patients. A scoring system rendered from this study suggests that patients with a total scoring at or above 8 should be considered for elective tracheostomy.
  
  
  CONCLUSIONS
  With appropriate postoperative monitoring, selected patients can be managed without routine elective tracheostomy, yet, patients with comorbidities, mostly elderly patients, which undergo surgical resection and reconstruction in high-risk areas that can result in a bulky flap that pose danger to the postoperative airway, should receive elective tracheostomy.
authors: *Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus †Bruce Rappaport Faculty of Medicine, Technion ‡Department of Anesthesiology, Rambam Health Care Campus, Haifa §Department of Maxillofacial Surgery, Baruch Padeh Medical Center, Poriya, The Faculty of Medicine, Bar Ilan University, Galilee ||Department of Otolaryngology Head and Neck Surgery, Bnai Zion Medical Center, Haifa, Israel.
authors: Yoav
authors: Y
authors: Leiser
authors: Michal
authors: M
authors: Barak
authors: Yasmine
authors: Y
authors: Ghantous
authors: Noam
authors: N
authors: Yehudai
authors: Imad
authors: I
authors: Abu El-Naaj
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000517:prevention & control*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D012509:Sarcoma / Q000601:surgery; D013524:Surgical Flaps; D014139:Tracheostomy; D055815:Young Adult