A study of tracheotomy performed under local anesthesia

We reviewed 41 cases of tracheotomy under local anesthesia. Thirty cases demonstrated malignant disease including laryngeal cancer (12 cases) and hypopharyngeal cancer (8 cases), whereas the remainder demonstrated benign disease. Twenty-eight cases underwent tracheotomy on the first hospital day, and 8 cases on the second hospital day. Reasons for tracheotomy included: to avoid asphyxia caused by airway narrowing (32 cases); preventional tracheotomy (4 cases); bleeding in the oral cavity or pharnx (4 cases); other reasons (1 case). Postoperative complications occurred in 5 cases which were however not serious. Clinical outcomes are that 17 patients currently remain alive, 19 patients have died and the current status of 5 patients is unknown. In this series, the average survival period of patients who died was 24.4 weeks after tracheotomy. Head and neck surgeons should have thorough knowledge and surgical techniques adapted to difficult tracheotomy procedures.