Changing indications for tracheostomy in maxillofacial trauma.

PURPOSE

Tracheostomy is one of the most common surgical procedures, but not always without complications. The purpose of this article was to reevaluate the indications of maintaining the airway with the use of tracheostomy.

MATERIALS AND METHODS

A total of 399 patients with maxillofacial trauma, who were treated in the Maxillofacial Surgery Department from 1985 to 1992, were evaluated for the type of fracture and air-way problems.

RESULTS

Out of the 399 patients evaluated, 13 needed a tracheostomy. Of these, 6 had had a cricothyroidotomy on arrival, 3 required tracheostomy because of impending airway obstruction, 3 because of respiratory distress, and 1 due to difficulty in intubation.

CONCLUSIONS

The results of this study indicated that surgically securing the airway by tracheostomy should be revised compared to other available methods. In the era of rigid fixation of fractures and the possibility of leaving the patient with an open mouth, it is unnecessary to carry out tracheostomy for securing the airway as frequently as in the past.