BACKGROUND For percutaneously tracheostomized patients with prolonged weaning and persisting respiratory failure, the adequate time point for safe decannulation and switch to noninvasive ventilation is an important clinical issue. OBJECTIVES We aimed to evaluate the usefulness of a tracheostomy retainer (TR) and the predictors of successful decannulation. METHODS We studied 166 of 384 patie...

PURPOSE This study was designed to evaluate the effect of tracheostomy site suturing after decannulation on swallowing rehabilitation, the incidence of postoperative complications, the length of hospital stay, and overall cost saving in patients undergoing major head and neck cancer resections. DESIGN Prospective, randomized, blinded, controlled clinical trial. METHODS Seventy-five patients...

BACKGROUND Weaning from tracheostomy has implications in management, quality of life, and costs of ventilated patients. Furthermore, endotracheal cannula removing needs further studies. Aim of this study was the validation of a protocol for weaning from tracheostomy and evaluation of predictor factors of decannulation. METHODS Medical records of 48 patients were retrospectively evaluated. Pat...

BACKGROUND Endoprosthesis are being used in the everyday clinical practice either as a permanent solution or transient. They can be used in both benign and malignant situations. CASE PRESENTATION We report a case in which a temporary Montgomery cannula is used in conjunction with therapeutic bronchoscopy to manage a patient with failed tracheostomy decannulation secondary to a distal complex ...

OBJECTIVES/HYPOTHESIS To determine risk factors for decannulation failure after laryngotracheal reconstruction performed at a single institution over a 10-year period. STUDY DESIGN This is a retrospective cohort study. METHODS The study population included 95 adult patients who underwent laryngotracheal reconstruction at a single tertiary care medical center between 2003 and 2012. Data were...

OBJECTIVE Variables predicting optimal timing for tracheostomy decannulation remain unknown. We aimed to determine whether classifying patients into two groups according to their indications for tracheostomy could identify variables associated with time to decannulation. DESIGN A prospective, observational cohort study was carried out. LOCATION Two medical-surgical ICUs. PATIENTS We inclu...

OBJECTIVE To analyze the impact of decannulation before intensive care unit discharge on ward survival in nonexperimental conditions. DESIGN Prospective, observational survey. SETTING Thirty-one intensive care units throughout Spain. PATIENTS All patients admitted from March 1, 2008 to May 31, 2008. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS At intensive care unit discharge, we...

Commonly encountered difficulties during decannulation are tube dependency, bleeding, and mechanical problems with cuff, aspiration, pulmonary complications, tracheomalacia, scarring of the tracheostomy wound, inversion of wound margin in skin, tracheal stenosis and also migration of granulation tissue inside the trachea through the tracheostomy wound. Patients with traumatic quadriplegia follo...

OBJECTIVE To compare postoperative respiratory and swallowing functions between patients who underwent classic supracricoid laryngectomy (SCL) and those who underwent SCL with laryngeal reconstruction using the sternohyoid muscle. STUDY DESIGN Prospective study. SETTING National cancer center. SUBJECTS AND METHODS Forty-four patients who consecutively underwent SCL for laryngeal squamous ...

With intensive care patients, decannulation and deglutition disorders are frequent reasons for otorhinolaryngological assessment. The objective of a tracheostomy is to maintain a patent airway. It does not necessarily prevent episodes of aspiration and may even favour them. When the cause that led to the tracheostomy resolves, a decannulation may be proposed. Deglutition is a complex act involv...