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Mini Tracheostomy for Obstructive Sleep Apnea:An Evidence Based Proposal


Affiliations
1 Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, HI 96859, United States
2 Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
3 Wright State University Boonshoft School of Medicine, Dayton, OH 45435, United States
4 Department of Otorhinolaryngology, Sleep Medicine Centre, Hospital CUF Porto, 4100-180 Porto, Portugal
 

Objective: To search for articles evaluating the use of tracheostomies (either permanent stomas or tracheostomy tubes) in adult obstructive sleep apnea (OSA) patients and to evaluate the potential for the use of mini tracheostomies as treatment for OSA. Study Design: Systematic review. Methods: Nine databases were searched from inception through July 21, 2015. Results: The overall tracheostomy search yielded 516 articles, of which eighteen studies provided polysomnographic data. No study was identified (empty review) for the use of mini tracheostomies for treating OSA. The mini tracheostomy search yielded ninety-five articles which describe findings for either mini tracheostomy kits (inner cannula diameter of 4 mm) or the performance of mini tracheotomies. Six articles described the use of mini tracheostomies as a temporary procedure to relieve acute upper airway obstruction and none described the use for OSA. For tracheostomy stomal sites, suturing the skin directly to the tracheal rings with defatting can minimize stomal site collapse. The smallest tracheostomy stomal size that can successfully treat OSA has not been described. Conclusion: Mini tracheostomies as small as 4mm have been successfully used in the short termto relieve upper airway obstruction. Given that polysomnography data are lacking, additional research is needed.
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  • Mini Tracheostomy for Obstructive Sleep Apnea:An Evidence Based Proposal

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Authors

Macario Camacho
Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, HI 96859, United States
Soroush Zaghi
Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States
Edward T. Chang
Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, HI 96859, United States
Sungjin A. Song
Otolaryngology-Head and Neck Surgery, Tripler Army Medical Center, HI 96859, United States
Blake Szelestey
Wright State University Boonshoft School of Medicine, Dayton, OH 45435, United States
Victor Certal
Department of Otorhinolaryngology, Sleep Medicine Centre, Hospital CUF Porto, 4100-180 Porto, Portugal

Abstract


Objective: To search for articles evaluating the use of tracheostomies (either permanent stomas or tracheostomy tubes) in adult obstructive sleep apnea (OSA) patients and to evaluate the potential for the use of mini tracheostomies as treatment for OSA. Study Design: Systematic review. Methods: Nine databases were searched from inception through July 21, 2015. Results: The overall tracheostomy search yielded 516 articles, of which eighteen studies provided polysomnographic data. No study was identified (empty review) for the use of mini tracheostomies for treating OSA. The mini tracheostomy search yielded ninety-five articles which describe findings for either mini tracheostomy kits (inner cannula diameter of 4 mm) or the performance of mini tracheotomies. Six articles described the use of mini tracheostomies as a temporary procedure to relieve acute upper airway obstruction and none described the use for OSA. For tracheostomy stomal sites, suturing the skin directly to the tracheal rings with defatting can minimize stomal site collapse. The smallest tracheostomy stomal size that can successfully treat OSA has not been described. Conclusion: Mini tracheostomies as small as 4mm have been successfully used in the short termto relieve upper airway obstruction. Given that polysomnography data are lacking, additional research is needed.