Excision of the Trachea Without Transient Tracheal Extubation in Total Laryngectomy: A Safer Technique

Abstract

Paul Oserhemhen Adobamen, Godwin Obasikene

Objective: The aim of this study was to describe a simple method of excision of the trachea without transient tracheal extubation, while comparing it with the excision of the trachea involving transient tracheal extubation in total laryngectomy, using the oxygen saturation of the patient as the basis for comparison. Methods: This was a retrospective study that was carried out at the University of Benin Teaching Hospital, Benin City, between January 2009 and December 2010, using the case notes of patients who had total laryngectomy for advanced laryngeal carcinoma. The study involved 22 patients who were divided into two groups: the first group had total laryngectomy in which the trachea was excised during transient tracheal extubation and the second group had total laryngectomy involving tracheal excision without transient tracheal extubation. The oxygen saturation of the patients, as recorded in the case notes between excision of the trachea and two (2) minutes after tracheal excision to note changes in their value, was also noted. Results: The group that had transient tracheal extubation for tracheal excision during laryngectomy had severe oxygen saturation reduction, while the group that did not have transient tracheal extubation for tracheal excision had negligible or no reduction in oxygen saturation, and there was no associated panic during the period of tracheal excision in this second group. Conclusion: Excision of the trachea without transient tracheal extubation during total laryngectomy appears to be a safer technique.