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Predictive Nomogram for the Necessity of Tracheotomy During Oral and Oropharyngeal Cancer Surgery
Author(s) -
Xu Siyuan,
Wang Kai,
Liu Kan,
Liu Yang,
Huang Ying,
Zhang Ye,
Wang Xiaolei,
Xu Zhengang,
Liu Shaoyan,
Liu Jie
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.29121
Subject(s) - nomogram , medicine , tracheotomy , neck dissection , airway obstruction , head and neck cancer , surgery , cancer , airway , radiation therapy
Objectives/Hypothesis The individualized risk of airway obstruction after head and neck cancer surgery is unclear, especially oral and oropharyngeal cancer. The study aimed to establish an individualized predictive model for the necessity of temporary tracheotomy in these patients. Methods Patients who underwent oral and oropharyngeal cancer surgery from 1999 to 2019 were retrospectively reviewed. A nomogram was developed and validated in patients treated from 1999 to 2009 and 2010 to 2019, respectively. Results In total, 1551 patients were included. Oropharyngeal cancer, large tumor, midline crossing, preoperative radiation, mandibulectomy, flap reconstruction, and neck dissection were independent risk factors of postoperative airway obstruction in the training group ( n = 707). A nomogram incorporating these factors had a C‐index of 0.931 and was validated in the testing group ( n = 844) (C‐index, 0.918). Good calibration curves were observed in both groups. Conclusions The nomogram successfully predicted the individual risk of postoperative airway obstruction for patients with oral and oropharyngeal cancer. Level of Evidence 4. Laryngoscope , 131:E1489–E1495, 2021