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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentations 3 - Laryngology/Broncho-Esophagology

Quantitative Analysis of Open vs Percutaneous Tracheostomy Techniques

Monday, September 30, 2024
9:42 AM – 9:48 AM EDT
Location: MBCC, 224
Disclosure(s):
Casey A. Collet, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Benjamin H. Tam, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Elizabeth A. Shuman, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Studies comparing outcomes of open versus percutaneous tracheostomy remain limited due to a lack of standardized design and the critically ill nature of these patients. From anecdotal experience, tracheostomy-related stenosis can vary in severity based on the degree of tracheostomy malposition. This study aims to quantify tracheostomy tube malposition using CT scans and compare amongst tracheostomy techniques.

Methods: All tracheostomies performed at one institution for prolonged mechanical ventilation by all techniques from August 2009 to July 2019 were evaluated. Blinded reviewers analyzed postoperative CT scans in the axial view at the initial entry point of the tracheostomy tube into the trachea. Tracheostomy angle of entry from midline and distance from midline were measured. CTs were also evaluated for the presence or absence of tracheal stenosis.

Results: Out of 900 tracheostomies, 191 had a postoperative CT scan. Of those, 40 patients underwent open OR tracheostomy (OOT), 115 underwent open bedside tracheostomy (OBT), and 36 underwent a percutaneous tracheostomy (PT). OOT had a smaller angle of entry from midline at 9.96° versus OBT (13.62°) and PT (13.08°). PT had a shorter distance from midline at 1.52 mm compared to OOT (2.33 mm) and OBT (3.08 mm). Rates of stenosis in patients with OOT was 37.5%, OBT was 36.5%, and PT was 13.9%.

Conclusions: Using a novel analysis, open tracheostomies were more likely to enter further from midline, though OOT exhibited a smaller entry angle. Further study is needed to determine the clinical significance of these findings.

    Presenting Author(s)

  • Casey A. Collet, MD

    Resident
    Keck School of Medicine of USC
    Los Angeles, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Casey A. Collet, MD

    Resident
    Keck School of Medicine of USC
    Los Angeles, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • MP

    Marcus F. Paoletti, BA

    Medical Student
    Keck School of Medicine
    Los Angeles, CA, United States

    Disclosure information not submitted.

  • MP

    Marcus F. Paoletti, BA

    Medical Student
    Keck School of Medicine
    Los Angeles, CA, United States

    Disclosure information not submitted.

  • Benjamin H. Tam, MD

    Resident Physician
    University of Nevada Las Vegas
    Anaheim, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Benjamin H. Tam, MD

    Resident Physician
    University of Nevada Las Vegas
    Anaheim, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • ML

    Matthew E. Lin, MD

    Resident Physician
    Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA
    Los Angeles, California, United States

    Disclosure information not submitted.

  • ML

    Matthew E. Lin, MD

    Resident Physician
    Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA
    Los Angeles, California, United States

    Disclosure information not submitted.

    • Presenting Author(s)

  • Elizabeth A. Shuman, MD

    Assistant Professor
    Keck School of Medicine of USC
    Los Angeles, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Elizabeth A. Shuman, MD

    Assistant Professor
    Keck School of Medicine of USC
    Los Angeles, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Elizabeth A. Shuman, MD

    Assistant Professor
    Keck School of Medicine of USC
    Los Angeles, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Elizabeth A. Shuman, MD

    Assistant Professor
    Keck School of Medicine of USC
    Los Angeles, CA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Karla D. O'Dell, MD

    Associate Professor
    Caruso Department of Otolaryngology – Head and Neck Surgery, Keck School of Medicine, University of Southern California
    Sherman Oaks, CA, United States

    Disclosure information not submitted.

  • Karla D. O'Dell, MD

    Associate Professor
    Caruso Department of Otolaryngology – Head and Neck Surgery, Keck School of Medicine, University of Southern California
    Sherman Oaks, CA, United States

    Disclosure information not submitted.