Use of nasotracheal intubation in patients receiving oral cavity free flap reconstruction.

Abstract

The aim of this study was to evaluate the effect airway management has on perioperative outcomes of patients undergoing oral cavity free flap reconstruction. A retrospective review was performed on patients receiving oral cavity free flap reconstruction between March 2006 and October 2007. Patient, tumor, and treatment variables were recorded. Patients were managed with nasotracheal intubation (NTI) or elective tracheotomy and different perioperative outcomes were measured. Thirty-seven patients received NTI and 21 received tracheotomy. No patients in the NTI group required conversion to tracheotomy or reintubation. The mean total hospital stay was prolonged in the tracheotomy group (12.4 days vs 8.4 days), as was their likelihood of requiring a feeding tube at discharge (76% vs 19%). In multivariate analyses, placement of a tracheotomy was independently correlated with longer hospital stay and feeding tube dependence at discharge. NTI is a safe alternative to tracheotomy for select patients receiving oral cavity free flap reconstruction and may reduce hospital stay and feeding tube dependence at discharge.