Abstract
Elective tracheostomy is routinely performed in conjunction with major head and neck surgery, notably during transoral robotic base of tongue resection and oral cavity/oropharyngeal resection with free flap reconstruction, due to concern for potential post-operative airway compromise. In these circumstances, the tracheostomy is typically intended to be temporary with reversal during the post-operative stay.
Highlights
Elective tracheostomy is routinely performed in conjunction with major head and neck surgery due to concern for potential post-operative airway compromise
Securing the airway through tracheostomy placement is often necessary for transoral robotic surgery (TORS) for base of tongue (BOT) resection and for oral cavity or oropharyngeal resections with free flap reconstruction [1,2,3,4]
One patient who underwent a TORS BOT resection had a tracheostomy placed at the onset of the case which was reversed intra-operatively following tumor resection
Summary
Elective tracheostomy is routinely performed in conjunction with major head and neck surgery due to concern for potential post-operative airway compromise. Securing the airway through tracheostomy placement is often necessary for transoral robotic surgery (TORS) for base of tongue (BOT) resection and for oral cavity or oropharyngeal resections with free flap reconstruction [1,2,3,4]. For TORS BOT resection, tracheostomy may be required for circumstances in which presence of an endotracheal tube may obstruct the surgical field. Tracheostomy may be temporarily required due to post-operative airway concern secondary to post-operative edema or bleeding. In the case of oral cavity or oropharyngeal resection with free flap reconstruction, airway concerns arise secondary to post-surgical edema as well as placement of new soft and/or bony tissue in close proximity to the oral airway [3,4].
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