A Study on Quality of Life in Post-tracheostomised Patients.

Introduction: Tracheostomy is a complex procedure which includes special care and attention with respect to the stoma and wound. But apart from surgical pitfalls certain qualities of life are also affected which needs due consideration for positive prognostic outcomes. Objective: To assess the quality of life in post tracheostomised patients. Materials and Methods: This study was a hospital based observational study conducted for a period of one year and included 97 patients. All patients underwent tracheostomy in ENT department and Central ICU. Nineteen post tracheostomy quality of life parameters were evaluated in 1st, 4th and 12th week interval. Results: 83.51% were male belonging to 6th and 7th decade. Most of them were tracheostomised on emergency basis (90.72%) for malignant causes (82.47%) and 95.88% of them had it for temporary period of time. Aryepiglottic folds were the most common site of malignant lesion. In the 1st week post tracheostomy, all parameters were affected except taste, smell and aesthetic state whereas in the following weeks it was employment, anxiety and voice production which were the affected quality of life. Conclusion: Most people had upper airway malignant growth and due to late presentation, they had to be put under emergency tracheostomy. Thus, leading to less time in pre-operative counselling that is a must in improving post-operative period quality of life. Awareness is required for timely screening of patients from 5th decade onwards so that adequate and timely treatment can be provided.

Cut Neck, Department of E.N.T in a Tertiary Centre: How We Approach.

Cut neck injury needs prolonged hospitalization, high cost care, reduced quality of life and above all death. Proper exploration is a must in preventing co-morbidities like shock, sepsis, laryngotracheal stenosis or fistula formation. Neck trauma can involve muscles, vessels, nerves, bone and hollow viscera. Though the repair of neck means planning and skill for repair of the structure, the tracheal repair needs special attention to avoid tracheal stenosis. 12 patients were included in the prospective study of 8 months. Management plan was undertaken which were thoroughly studied and discussed with respect to two tracheoplasty cases done in ENT OT, AMCH. Apart from haemodynamic stability all patients were assessed for injury to hollow viscera and planned accordingly as this centre is an important centre for airway reconstruction. Male female ratio was 11:1. Suicidal cut neck injury was the most common cause. Two cases were of tracheal stenosis post tracheostomy. One of the case had associated neurovascular injury but with patent airway. Rest of the cases were repaired under general and/or local anaesthesia. Primary aim should be to maintain airway and to look for the extent of injury to reduce morbidity. Expertise of surgeons' skill is developing every day hence the successfulness of repair will be tested by least of morbidity. From this institute which is skilled in airway reconstruction we could comment that airway reconstruction team should be an integral part of surgeons' team.