Objectives: The purpose of this study is to evaluate the incidence of complications accompanying tracheostomy, and in addition, to suggest ways to prevent serious complications. Materials and Methods: We performed tracgeostomy in
168
patients and their data were analyzed retrospectively. Results: Twenty one patients (12.5%) had complications directly related to tracheostomy. The most common complication was postoperative bleeding which accounted for 11 cases (6.7%).
Others
complications included pneumothorax which claimed 3 cases (1.8%) with reduced morbidity, cannula dislodgment claimed 3 cases (1.8%), cannula obstrucion 2, wound infection 2 and tracheal stenosis 2. Among them two patients were decannulated
without
difficulty. The rest of patients could not be decannulated because of various reasons including death, underlying disease, subglottic stenosis, tracheal stenosis or vocal cord palsy. Conclusion: In order to avoid complications of
tracheostomy, it
is important to treat preoperatively the tendency to bleeding, and meticulously control it during the operation as well. Also, the use of longer cannulas and tracheal fenestration technique is helpful for patients with short and stocky neck.
Positive
pressure applied through the cannula can make serious complications such as pneumothorax when cannula-obstruction or cannula-dislodgment is suspected and the high volume-low pressure cuff is useful to prevent the decannulation difficulties by
longterm
cannulation, espcially in patients using ventilator.
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