Evaluation of tracheal narrowing post tracheostomy by plain X-ray

ABSTRACT

The objective of this work is to recognize the incidence and severity of narrowing of the trachea in the head and neck surgical patients who had undergone tracheostomy by doing lateral cervical X-ray. This is a prospective study of 24 adult patients with consecutive tracheostomies conducted in the period from January 2008 to January 2009 in E.N.T Department, Al- Yarmouk Teaching Hospital. Twenty of them [83.3%] had emergency tracheostomy and 4 of them [16.6%] had elective tracheostomy. Analysis was performed with respect to age, sex, time of decannulation, symptoms and the type of operation whether emergency or an elective procedure. The diagnosis of tracheal narrowing after decannulation depends on lateral soft tissue X-ray of the neck. Diameter of the trachea above the stoma [around 2 cm below the cricoid ring that can be clearly seen in lateral X-ray] was taken as control. The study revealed that 83.3% of patients developed narrowing of the trachea post-tracheostomy, however, all the narrowing cases was less than 50%. Very early decannulation of tracheostomy tube showed minimum or no narrowing at all. There is gradual narrowing in patients in whom decannulation were performed after 2 weeks. Male patients had earlier decannulation time compared to female patients. Tracheostomy as live saving procedure results in minimum asymptomatic tracheal stenosis