Abstract
Background: known since more than 5000 years, tracheotomy is indicated in severe obstructions of the upper airways or in improvement of ventilation in cases of problematic tracheal intubation. Its usefulness and efficiency are certain, but it needs regular assessments. Aim: to determine the frequency of tracheotomies in ENT at CNHU of Cotonou, identify the indications, surgical technics and the postoperative course. Materials and methods: the study was retrospective, based on files of patients who have had tracheotomies for ten years since 2010. Results: in 10 years, 105 tracheotomies were performed for 99 patients, average 10 to 11 per year. Patients were male in 61.9%. Extreme of age where 09 months and 80 years old. Children under15 were concerned in 41.9%, while patients from 45 to 64 years old in 33.3%. Emergency tracheotomy represented 76%. Causes were tumors in 62.8%. Laryngeal papillomatosis was the predominant tumor in children; 28 cases or 26.67%. In adults, larynx cancer represented 20%. Skin incisions were horizontal in 94.3%. Tracheal opening was “H-shaped” in 92.4%. Complications occurred in 28.6%. They included granuloma (13.3%) and oeso-tracheal fistula (1.9%). Decanulation was possible in 87.6%, but it was more difficult in children. Conclusion: tracheotomy was an act of rescue in our practice.
Highlights
Tracheotomy is the temporary or permanent opening of the trachea followed by the placement of a cannula
Sub-Saharan Africa is associated with low socioeconomic populations, few ENT who are concentrated in the main urban areas, and limitations in terms of health facilities. These factors have implications such as: - Late consultations of patients often seen in an emergency context in which tracheotomy is the first procedure performed, sometimes under difficult conditions. - Increasingly frequent demand for tracheotomy, linked to the increase in indications and the creation of intensive care units whose equipment does not always follow. - Limits for the specific management of the causal affection, tracheotomy being sometimes the only therapeutic gesture practiced
The inclusion criteria were: - All tracheotomies performed in the CNHU HKM of Cotonou. - Tracheotomy performed by a Physician (Resident or Senior) from the ENT
Summary
Tracheotomy is the temporary or permanent opening of the trachea followed by the placement of a cannula. It is an important procedure in the treatment or prevention of respiratory emergencies in ENT [1]. Sub-Saharan Africa is associated with low socioeconomic populations, few ENT who are concentrated in the main urban areas, and limitations in terms of health facilities. These factors have implications such as: - Late consultations of patients often seen in an emergency context in which tracheotomy is the first procedure performed, sometimes under difficult conditions. The aim of this study was to determine the incidence of tracheostomy in ENT at the National Teaching school of Medecine of Cotonou (CNHU HKM), and to identify the indications with the causal conditions, the techniques used and the results
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