title: Tracheostomy in the Morbidly Obese: Difficulties and Challenges.
abstract: OBJECTIVE
  This study evaluated the difficulties and challenges associated with open tracheostomy in the morbidly obese patient (body mass index [BMI] ≥30 kg/m2).
  
  
  METHODS
  Forty patients met all the inclusion criteria. A retrospective chart review was performed to evaluate indications for tracheostomy, duration of intubation before tracheostomy, history of tracheostomy, duration of operative procedure, duration in the operating room, and all perioperative complications.
  
  
  RESULTS
  Complications were classified as intraoperative (5%) and postoperative (17.5%). The average BMI was 46 kg/m2(range, 31.1 to 75.3 kg/m2). The average duration of intubation before tracheostomy was 11 days. Ten patients (25%) previously underwent tracheostomy. The average operating time was 60 minutes (range, 20 to 95 minutes). The average total time in the operating room was 100 minutes (range, 45 to 146 minutes).
  
  
  CONCLUSIONS
  This study shows that although open tracheostomy in the morbidly obese patient is increasing in demand, the procedure can be predictably performed albeit at a much longer duration and a higher perioperative complication rate compared with the traditional tracheostomy.
authors.affiliation: Chair, Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, FL. Electronic address: Tirbod.Fattahi@Jax.Ufl.Edu.
authors.forename: Tirbod
authors.initials: T
authors.lastname: Fattahi
authors.affiliation: Chief Resident, Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, FL.
authors.forename: Christopher
authors.initials: C
authors.lastname: Chafin
authors.affiliation: Fellow in Head and Neck Surgery, Department of Oral and Maxillofacial Surgery, University of Florida, Jacksonville, FL.
authors.forename: Anthony
authors.initials: A
authors.lastname: Bunnell
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid; D019647:Oral Surgical Procedures; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D014139:Tracheostomy / Q000379:methods*