Airway obstruction after tracheotomy

Introduction Obstruction of the upper airway is one of the most important emergency situations in otorhinolaryngology. Mechanical obstruction of the airway can be caused by tumours, inflammation or injury in the pharyngeal and laryngeal region as well as aspiration of foreign bodies.

One of the most important methods of securing the airway is surgical tracheostomy.

However, there are also situations after tracheotomy where the airway is at risk.

The aim of our work is to identify the most common risks and to develop preventive measures.

Material and methods Retrospective data collection from the Bielefeld Mitte Clinic.

Results The presentation of tracheotomised patients to the clinic was mostly via the emergency room. Symptoms were, for example, shortness of breath, coughing fits and possibly stridor.

The most frequent causes included dislocation of the cannula with shrinkage of the tracheostoma, borky tracheitis due to poor cannula care, and bleeding from tumours or during anticoagulation or manipulation of the cannula.

Most cases occurred in patients with dementia, patients from nursing homes or in patients with anticoagulants in their medication. 

The emergency treatment was the removal of the foreign body and the insertion of a large-lumen cannula with overblocked cuff pressure.

Conclusion Based on the results, regular monitoring of the further indication of anticoagulant therapy, for example by the general practitioner, as well as close tumour follow-up and intensive care of the tracheostoma by trained personnel are particularly useful in reducing the most frequent risks of these airway obstructions.

Publication History

Article published online:
24 May 2022