Abstract
Objective: To see the common indications, pattern of complications (during and post operative) of emergency tracheostomy in the tertiary level hospital in Bangladesh. It also gives the idea for minimizing the complications.
 Methods: This cross sectional study was carried out in the Department of Otolaryngology & Head- Neck surgery of Dhaka Medical College Hospital, Dhaka, from 14th April 2015 to 14th October 2015. This study includes all emergency patients irrespective of age and sex whose tracheostomy was done in emergency operation theatre of ENT department of Dhaka Medical College and Hospital.
 Results: The study reveals that the commonest indications of emergency tracheostomy were diagnosed case of carcinoma of larynx & base of tongue (30%) followed by post-irradiated carcinoma larynx (24%). Next common indications were stridor in undiagnosed case (18%), difficulty in intubation during surgery (10%), history of road traffic accident (6%), cut throat injury (6%), foreign body in throat (2%), laryngeal edema and blunt trauma in neck (2%) respectively. Commonest complications during the procedure were apnoea (12%), haemorrhage (18%), injury to surrounding structure (10%), cardiac arrest (4%) & respiratory arrest (2%). Common complications in early post operative period were surgical emphysema (10%), crusting or blockage (4%), tube dislodgement (4%), &stomal infection (2%). Late post operative complications were stomal granulation tissue (4%), pneumonia (2%), stomal infection (2%), tracheocutaneous fistula (2%), & tracheomalasia (2%).
 Bangladesh J Otorhinolaryngol; October 2016; 22(2): 96-101
Highlights
Tracheostomy is used to describe as the creation of a stoma at the skin surface which leads into the trachea.[1]
Many critically ill patient’s families have been denied in authorizing tracheostomy because of cosmetic issues and speech problem.[4,5]. This was a cross-sectional study done at the Department of Otolaryngology and Head-Neck surgery of Dhaka Medical College Hospital, Dhaka for six months, from 14th April 2015 to 14th October 2015
In this study 50 cases of emergency tracheostomy were performed in the emergency operation theatre in the Otolaryngology & Head- Neck surgery department of Dhaka Medical College
Summary
Tracheostomy is used to describe as the creation of a stoma at the skin surface which leads into the trachea.[1] The word tracheostomy comes from two Greek words: the root tom- meaning ‘to cut’ and the word trachea means wind pipe.[2]. Despite being one of the most common surgical procedures tracheostomy can be one of the most challenging because of the medical complexities presented by many patients. Tracheostomy was first described nearly 3500 years ago. The first successful tracheostomy is attributed to Antonio Musa Brasaralo, who published his account of procedure in 1546 AD. Chevalier Jackson’s description of his modifications to the procedure, published in 1909, improved its efficiency and safety and reduced the mortality of tracheostomy from 25% to 2%.3
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