Update on the pattern of tracheostomies at a tertiary health institution after 27 years

Objective: To determine any change in the incidence, indications and complications of tracheostomy in the University of Nigeria Teaching Hospital after 27 years.Method: All tracheostomies performed in the five-year period ending December 2004 were identified from our theater records. The age and sex of the patients, rank of the surgeon, indications and complications were ascertained by retrospective case note review. The results were compared with the results of a similar work done between 1973 and 1978.Results: In the 5- year under review, 52 tracheostomies were performed, with an average of 10.4 tracheostomies per year. The age range was 11 months – 90 years. The highest incidence was in the age group of 0-20 years. Male to female ratio was 1.4:1. The commonest indication was for the relief of upper airway obstruction. The common causes of upper airway obstruction were laryngeal carcinoma and laryngeal foreign bodies. Complications occurred in 38.2% of the patients. Commonest complication was surgical emphysema. Mortality rate was 3.8%.Conclusion: There was a reduction in the frequency of tracheostomy operations (P< 0.001). Upper airway obstruction still remains the commonest indication for tracheostomy. However, acute laryngeal infection as an indication for tracheostomy in children diminished. There was no significant change in the mortality rate. Keywords: tracheostomy, incidence, indications, complications Nigerian Journal of Otorhinolaryngology Vol. 3(1) 2006: 8-1