Valentine Poissonnet1, Emilien Chabrillac1, Philippe Schultz2, Sylvain Morinière3, Philippe Gorphe4, Bertrand Baujat5, Renaud Garrel6, Audrey Lasne-Cardon7, Alexandre Villeneuve8, Guillaume Chambon9, Nicolas Fakhry10, Karine Aubry11, Xavier Dufour12, Olivier Malard13, Romina Mastronicola14, Benjamin Vairel1, Patrice Gallet15, Philippe Ceruse16, Franck Jegoux17, Jean Ton Van18, Guillaume De Bonnecaze1, Sébastien Vergez19,20. 1. Otolaryngology, Head and Neck Surgery Department, University Cancer Institute Toulouse and Toulouse University Hospital, Hôpital Larrey, Toulouse, France. 2. Otolaryngology, Head and Neck Surgery Department, Hautepierre Hospital, Strasbourg, France. 3. Otolaryngology, Head and Neck Surgery Department, University Hospital Bretonneau, Tours, France. 4. Otolaryngology, Head and Neck Surgery Department, Gustave Roussy Institute, Villejuif, France. 5. Otolaryngology, Head and Neck Surgery Department, Tenon Hospital, Paris, France. 6. Otolaryngology, Head and Neck Surgery Department, University Hospital of Montpellier, Montpellier, France. 7. Otolaryngology, Head and Neck Surgery Department, François Baclesse Centre, Caen, France. 8. Otolaryngology, Head and Neck Surgery Department, Georges-Pompidou European Hospital, Paris, France. 9. Otolaryngology, Head and Neck Surgery Department, University Hospital of Nîmes, Nîmes, France. 10. Otolaryngology, Head and Neck Surgery Department, University Hospital of Marseille, Marseille, France. 11. Otolaryngology, Head and Neck Surgery Department, University Hospital Dupuytren, Limoges, France. 12. Otolaryngology, Head and Neck Surgery Department, University Hospital of Poitiers, Poitiers, France. 13. Otolaryngology, Head and Neck Surgery Department, University Hospital of Nantes, Nantes, France. 14. Surgical Oncology, Head and Neck Surgery Department, Lorraine Oncology Institute, Vandoeuvre-lès-Nancy, France. 15. Otolaryngology, Head and Neck Surgery Department, University Hospital of Nancy, Nancy, France. 16. Otolaryngology, Head and Neck Surgery Department, University Hospital Lyon Sud, Lyon, France. 17. Otolaryngology, Head and Neck Surgery Department, Pontchaillou Hospital, Rennes, France. 18. Surgical Oncology Head and Neck Surgery Department, Oscar Lambret Centre, Lille, France. 19. Otolaryngology, Head and Neck Surgery Department, University Cancer Institute Toulouse and Toulouse University Hospital, Hôpital Larrey, Toulouse, France. vergez.s@chu-toulouse.fr. 20. Otolaryngology, Head and Neck Surgery Department, University Hospital Larrey, 24 chemin de Pouvourville, 31059, Toulouse Cedex 9, France. vergez.s@chu-toulouse.fr.
Abstract
PURPOSE: The aim of the survey was to define the indications for preventive tracheostomy in transoral robotic surgery (TORS) for head and neck cancers. METHODS: From October 2019 to January 2020, an online questionnaire was e-mailed to French surgical ENT teams with considerable experience of the TORS procedure (Gettec group). A descriptive analysis of the answers was performed. RESULTS: Eighteen French surgical teams answered the questionnaire. For 77.8% of the surgical teams, a past history of radiotherapy with residual edema was an indication for prophylactic tracheostomy, and for 88.9%, > 75 mg of antiplatelet medication or anticoagulation treatment was an indication. CONCLUSION: Early preventive tracheostomy during TORS can protect airway from uncommon but potentially life-threatening complications, such as transoral hemorrhage or airway edema. We recommend it in high-risk situations, such as a past history of radiotherapy or antiplatelet therapy associated with large resections. Further studies are needed to establish evidence-based recommendations.
PURPOSE: The aim of the survey was to define the indications for preventive tracheostomy in transoral robotic surgery (TORS) for head and neck cancers. METHODS: From October 2019 to January 2020, an online questionnaire was e-mailed to French surgical ENT teams with considerable experience of the TORS procedure (Gettec group). A descriptive analysis of the answers was performed. RESULTS: Eighteen French surgical teams answered the questionnaire. For 77.8% of the surgical teams, a past history of radiotherapy with residual edema was an indication for prophylactic tracheostomy, and for 88.9%, > 75 mg of antiplatelet medication or anticoagulation treatment was an indication. CONCLUSION: Early preventive tracheostomy during TORS can protect airway from uncommon but potentially life-threatening complications, such as transoral hemorrhage or airway edema. We recommend it in high-risk situations, such as a past history of radiotherapy or antiplatelet therapy associated with large resections. Further studies are needed to establish evidence-based recommendations.
Authors: Victor Razafindranaly; Benjamin Lallemant; Karine Aubry; Sylvain Moriniere; Sébastien Vergez; Erwan De Mones; Oliver Malard; Philippe Ceruse Journal: Head Neck Date: 2015-10-05 Impact factor: 3.147
Authors: Steven M Olsen; Eric J Moore; Cody A Koch; Daniel L Price; Jan L Kasperbauer; Kerry D Olsen Journal: Am J Otolaryngol Date: 2011-11-30 Impact factor: 1.808
Authors: Kathryn M Van Abel; Melanie H Quick; Darlene E Graner; Christine M Lohse; Daniel L Price; Katharine A R Price; Dan J Ma; Eric J Moore Journal: Am J Otolaryngol Date: 2019-07-03 Impact factor: 1.808