Plastic tracheostomy and percutaneous dilatation tracheostomy.Synergy or competition?

Introduction Tracheostomy for airway management is an established and frequent procedure in both head and neck surgery and intensive care medicine. In addition to plastic tracheostomy, which is usually performed by ENT surgeons, percutaneous dialation tracheostomy has also become more common in the last decade and a half and is often performed by non-surgeons.

Patients and methods With reference to the experience of the last 5 years with both methods in our own clinic, the respective indications for the procedures, the complication possibilities and their management are reviewed and presented.

Results Depending on the underlying disease, the injury pattern, the necessary duration of ventilation via the tracheostoma, neurological disease and the planned further care, the decision on the method of tracheostomy must be made. Furthermore, it could be shown that the frequency of complications in dilatation tracheostomy is significantly lower when performed by an ENT specialist/head-and-neck surgeon.

Conclusions Plastic tracheostomy and percutaneous dilatation tracheostomy are procedures that can complement each other if the indication is correct. Due to the possible complications of PDT, some of which are considerable, this procedure should also be carried out by a trained surgeon with expertise in head and neck surgery.

Publication History

Article published online:
12 May 2023