Tracheostomy: Five-Year Review in a West African Hospital

The aim of this study was to determine the frequency of tracheotomies in our department over the last five (5) years, list the indications and explain the technique and postoperative follow-up. Material and Methods: This is a 5-year (January 2013-December 2017) retrospective and analytical study of the records of patients who have had tracheotomies in the ENT and Neck and Facial Surgery department of the Ignace Deen National Hospital in Conakry. Results: During this period, 48 tracheotomies were performed in the department, with a frequency of 5.42%. The mean age of our patients was 35 years with extremes of 9 years and 67 years. The age group from 10 to 19 was the most affected. The sex ratio was 1.67. All socio-professional categories were affected. The aetiologies of the air obstacle were dominated by cancerous lesions: laryngeal cancer, laryngeal papillomatosis and hypopharyngeal cancer, representing 22.92%, 20.83% and 14.58% of cases respectively. The tracheotomy was most often carried out under local anaesthesia with a supra isthmic tracheal opening in an inverted H or I shape in 77.08% of cases. Complications observed in our series were cervical emphysema and obstructive mucus plug in 6.25% of cases and 1 case of death, i.e. 2.08%. Early decanulation was performed in 41.67% of cases. Conclusion: Tracheostomy is a lifesaving procedure and commonly performed in our practice. A proper technique with carefully selected indications enables minimises the risk of complications.