David Goldenberg1, Sunny S Park, Michele Carr. 1. Division of Otolaryngology-Head and Neck Surgery, the Pennsylvania State University, The Milton S Hershey Medical Center, Hershey, PA 17033, USA. dgoldenberg@hmc.psu.edu
Abstract
OBJECTIVES: Percutaneous tracheotomy (PT) has been garnering attention in otolaryngology-head and neck surgery (OTO-HNS) community for many years. This procedure is used routinely by a variety of surgical disciplines; yet its use remains controversial especially in OTO-HNS. The purpose of this study is to understand the current practices pertaining to PT in OTO-HNS training programs. STUDY DESIGN: Multi-institution physician survey. METHODS: A survey of 102 American OTO-HNS residency program directors. RESULTS: The response rate was 80%. 29% of programs perform PT on a regular basis. Ciaglia Blue Rhino method was used by all respondents who could identify the method used. Simultaneous video bronchoscopy was always used by 91% of those who performed PT. Among respondents in programs where PT was not done regularly, 18% felt that it was the method of choice for selected patients; among those in programs where PT was done regularly, 72% felt that it was the method of choice. 64% of respondents indicated that other hospital services regularly performed PT in their institution, and this was evenly split between trauma, general surgery, pulmonology and intensive care unit (ICU). There was no significant difference in this regard between respondents from hospitals that did or did not do PT. 71% of OTO-HNS graduates are not trained in PT. CONCLUSIONS: Only 29% of otolaryngology residency programs in the U.S. perform PT regularly. This study objectively shows that this is a highly polarized subject amongst OTO-HNS but apparently not in medicine in general. Further study is needed to understand the reason for this controversy.
OBJECTIVES: Percutaneous tracheotomy (PT) has been garnering attention in otolaryngology-head and neck surgery (OTO-HNS) community for many years. This procedure is used routinely by a variety of surgical disciplines; yet its use remains controversial especially in OTO-HNS. The purpose of this study is to understand the current practices pertaining to PT in OTO-HNS training programs. STUDY DESIGN: Multi-institution physician survey. METHODS: A survey of 102 American OTO-HNS residency program directors. RESULTS: The response rate was 80%. 29% of programs perform PT on a regular basis. Ciaglia Blue Rhino method was used by all respondents who could identify the method used. Simultaneous video bronchoscopy was always used by 91% of those who performed PT. Among respondents in programs where PT was not done regularly, 18% felt that it was the method of choice for selected patients; among those in programs where PT was done regularly, 72% felt that it was the method of choice. 64% of respondents indicated that other hospital services regularly performed PT in their institution, and this was evenly split between trauma, general surgery, pulmonology and intensive care unit (ICU). There was no significant difference in this regard between respondents from hospitals that did or did not do PT. 71% of OTO-HNS graduates are not trained in PT. CONCLUSIONS: Only 29% of otolaryngology residency programs in the U.S. perform PT regularly. This study objectively shows that this is a highly polarized subject amongst OTO-HNS but apparently not in medicine in general. Further study is needed to understand the reason for this controversy.