Post-Thyroidectomy Tracheostomy at Three Teaching Hospitals in Khartoum

Background: Sudan is an endemic area of goitre, and thyroidectomy is a common operation in Khartoum. The most serious postthyroidectomy complication is airway obstruction, which may necessitate tracheostomy. This complication occurs most commonly in large goitres. Methods: This prospective cross-sectional study was conducted to find the incidence, indications, technique and complications of post thyroidectomy tracheostomy at three Teaching Hospitals in Khartoum (Khartoum Teaching Hospital, Soba University Hospital, and Police Teaching Hospital), between March 2000 - March 2002. All patients planed for thyroidectomy were interviewed with special interest in large goitres. Data were collected in a pre-designed questionnaire and then analyzed using computer and displaced in tables and figures. All patients were assessed clinically and radiological imaging of the neck was done. Pre and postoperative laryngeoscopy was routine in all patients. Results: Thirty-six patients underwent post thyroidectomy tracheostomy at a rate of 11% at Khartoum Teaching Hospital (n=31), 3.8% at Soba University Hospital (n=3), 2.4% at Police Teaching Hospital (n=2). The most common indication was found to be tracheomalacia, 36% (n=13). Tracheostomy opening was longitudinal in 57% of patients (n=20) flap stitched in 28(n=10) window excised in 15% (n=6). There were minimal complications such as cough in all patients. The mortality was one patient with benign goitre in whom tracheostomy was carried in the ward, and one patient during the change of the tube (tracheostomy was window excised). Conclusion: Tracheostomy was safe when carried as planned elective procedure. Flap stitched makes easy change and nursing. Tracheomalacia was common in our patient