Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2025, Vol. 39 ›› Issue (2): 87-93.doi: 10.6040/j.issn.1673-3770.0.2024.254

• Original Article • Previous Articles     Next Articles

Safety of bedside percutaneous dilational tracheotomy for elderly patients with mandibular lift in the supine position

LI Hui, ZHAO Yongqiang, HE Zhen, YANG Huimin, ZHAO Ye, TIAN Xiujuan, CHEN Jianqiu   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, 960th Hospital of the joint logistics support force of PLA, Jinan 250031, Shandong, China
  • Published:2025-03-26

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Abstract: Objective To study the feasibility and safety of percutaneous dilatational tracheotomy(PDT)at the bedside in elderly patients with mandibular lift in the horizontal position. Methods We retrospectively compared different tracheotomy methods with regard to the surgical incision length, procedure duration and safety of the procedure and complications. A total of 244 elderly patients in the wards underwent PDT, with mandibular lift in the horizontal position(ML-PDT)or with shoulder cushion in supine shoulder cushion position(SC-PDT)and conventional open surgical tracheotomy with supine shoulder cushion position(surgical tracheotomy, ST). The demographic characteristics and outcomes were recorded. Results There were more male patients than females, with a mean age of(82.8±7.2)years, and all patients successfully completed tracheostomy. The mean value of surgical incision length(P=0.002)and procedure duration(P=0.002)in the ML-PDT group and in SC-PDT group was significantly lower than those in the ST group, with a statistically significant difference(P<0.05). There was no difference(P>0.05)between ML-PDT and SC-PDT groups(Psurgical incision length=0.140, Pprocedure duration=0.162). Bleeding(P=0.007)and subcutaneous emphysema(P<0.001)and morbidity of complications(P<0.001)were significantly reduced significantly lower in ML-PDT group and SC-PDT group compared with in ST group, the difference was statistically significant(P<0.05). There were no differences(P>0.05)between ML-PDT and SC-PDT groups(Pbleeding=1.000、Psubcutaneous emphysema=1.000、Pgeneral complications=0.701、Ptotal complications=0.605). Accidental decannulation(P=0.447), accidental destubes air leak from the fistula(P=0.623), incision infection(P=0.156)and granulation(P=0.156)were also lower in ML-PDT group and SC-PDT group, however, there was no significant difference statistically among the three groups(P>0.05). Conclusion PDT with mandibular lift in the horizontal position can be performed on the bedside in elderly patients without shoulder cushion to tilt the head position change. The operation is rapid and simple, intraoperative and postoperative complications are few, which is safe and feasible.

Key words: Supine position, Mandibular lift, The elderly, Percutaneous dilatational tracheostomy

CLC Number: 

  • R762
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