One-Stage Decannulation Procedure for Patients Undergoing Oral and Oropharyngeal Oncological Surgeries and Prophylactic Tracheotomy

Objective: Decannulation of patients with tracheotomy usually requires decrease in tracheostomy tube size, capping for 24-48 hours and observation after tube removal. Delay in decannulation may increase cardiopulmonary load, prolong hospitalization and cause patient distress. We propose a one-stage procedure in an intensive care unit (ICU) setting for patients undergoing head and neck surgeries and temporary tracheotomy. Study Design and Setting: Patients undergoing resection of head and neck tumors involving the oral cavity or oropharynx in a tertiary cancer center were prospectively studied. Following clinical and laboratory assessments, the tracheostomy tube was removed under cardiopulmonary monitoring in the ICU. Results: All 24 study patients underwent successful decannulation and were discharged 24 hours later. Follow-up time was 5 months. None of them required reintubation or recannulation. Conclusion: A one-stage decannulation is feasible and safe for patients undergoing resection of head and neck tumors involving the oral cavity or oropharynx. This procedure may lessen hospitalization time and reduce patient's distress.