10 year evaluation of perioperative airway management in head and neck cancers with free flap reconstruction in a single unit

Abstract

Management of the airway prolonged ventilation versus elective tracheostomy has long been debated in the literature. We present a retrospective audit of 10 years of 469 free flap reconstruction in head and neck cancer cases in a single unit. 333 of these cases underwent prolonged intubation as part of their initial airway management, of which 16 underwent subsequent emergency tracheostomies. Whilst there are cases where elective tracheostomy is indicated, for example in bilateral neck dissections, surgeon choice or in a radiotherapy treated neck, it was difficult to predict which other cases might need an emergency tracheostomy.