Appropriateness of routine postoperative chest radiography after tracheotomy.

OBJECTIVE To determine the appropriateness of postoperative chest radiography after adult tracheotomy. DESIGN Retrospective case series. SETTING Tertiary care academic medical center. PATIENTS The records of 379 consecutive adult patients who underwent tracheotomy by the Otolaryngology-Head and Neck Surgery Service from January 1992 to December 1996 were available for review and met inclusion criteria. All patients underwent postoperative chest radiography. MAIN OUTCOME MEASURES Frequency of postoperative tracheotomy-associated complications, most significantly pneumothorax. RESULTS The patients had no pneumothorax on postoperative chest films. Minor complications, which were found in 7.1% of the patients, included small bleeds, wound infection, and subcutaneous emphysema. Tracheostomy-associated death occurred in 2 patients (0.5%). CONCLUSIONS Routine postoperative chest radiography is unnecessary after adult tracheotomy. Chest radiography may be indicated by clinically suspicious signs or symptoms.