GOOD AFTERNOON

CHARACTERISTICS OF THE PATIENTS

UNDERWENT TRACHEOSTOMY

IN ENT-HNS DEPARTMENT

IN SANGLAH HOSPITAL

FROM 2012-2014

By: Juniari

Scientific Advisor:

dr. I D.G.Arta Eka Putra, Sp.T.H.T.K.L

INTRODUCTION

TRACHEOSTOMY

operative procedure that creates a surgical airway

in the cervical trachea in patients with inadequate

ventilation or upper respiratory obstruction

location of the incision

the time of action

types of incisions

techniques

H. Adam Malik Hospital in Medan period 2006-2010

83 patients with tracheostomy action, male 83.1% and female 16.9%.

In ENT-HNS Department

Sanglah Hospital ?

BACKGROUND

ISSUE What is the characteristic of the patients underwent tracheostomy

in ENT-HNS Department in Sanglah Hospital in 2012-2014?

General: To know the characteristics of patients who underwent tracheostomy in

ENT-HNS Department in Sanglah Hospital in 2012-2014.

Spesific : To know the characteristics of patients who underwent tracheostomy based

on age, sex, cause of obstruction, stadium obstruction, time of action, technique of action,

location of incision, kind of incison

.

OBJECTIVE

BENEFIT - To provide an overview characteristics of patients

who underwent tracheostomy

- Information for other researchers who will conduct further

research related to the tracheostomy.

LITERATURE REVIEW ANATOMY & PHYSIOLOGY

Completed tracheotomy:

1. Vocal folds,

2. Thyroid cartilage,

3. Cricoid cartilage

4. Tracheal rings,

5. Balloon cuff.

Literature Review

DEFINITION & INDICATION OF TRACHESTOMY

operative procedure that creates a surgical airway in the cervical trachea in patients with

inadequate ventilation or upper respiratory obstruction

Indication:

1) overcoming upper airway obstruction, 2) support the provision of assistance breath

3) remove secretions from the tracheobronchial, 4)prevent aspiration

Jackson divided the progressive airway obstruction in four stages.

Tracheostomy is contraindicated if conservative measures is still to do

Literature ReviewTRACHESTOMY

Can divided into:

1.Location of incision

2.Kind of incision

3. Time of action

4. Technique of tracheostomy

Complication:

- intraoperative complications

- immediately complications

- late complications postoperative

Selection of tracheostomy tube depend on

patient's anatomy and clinical needs, should be rigid but

flexible enough to support adequate respiration and

comfortable for the patient.

Post Tracheostomy Care

Humidification of air, sucking secretions, replacement cannula

CONCEPTUAL FRAMEWORK

Age

Sex

Cause of obstruction

Stage of

obstructionTRACHEOSTOMY

Complication

Time of

action

Technique

Tracheostomy

Kind of

incision

Location of

incision

Elective

Emergence

Open

Percutaneus

Dilatation

Vertical

Horizontal

High

tracheostomy

Low

tracheostomy

CONCEPTUAL FRAMEWORK

MEDICAL RECORD

Patients underwent tracheostomy:

Age

Sex

Etiology

Stage of obstruction

Time of action

Technique of tracheostomy

Kind of incision

Location of incision

Complication

METHOD

Research Design

Place & TimeENT-HNS Department Sanglah Hospital

January 2012- December 2014 (3 Years Study)

Retrospective Design

Population All patients underwent tracheostomy

Sample

Sample = Population

Consecutive Sampling Technique

Inclusion

All patient underwent tracheostomy in ENT-HNS

Departement Sanglah Hospital from

January 2012 until December 2014

Exclusion Patients with incomplete medical record concerning

in studied variables

METHOD

OPERATIONAL DEFINITION

OF VARIABLE

Tracheostomy, age, sex, cause of obstruction, stage of obstruction, time of action,

technique of tracheostomy, kind of incision, location of action, complication.

Taken from the medical records of patients who underwent tracheostomy in the

ENT-HNS Department in Sanglah Hospital from Januari 2012 to December 2014.

The results of the examination are recorded in a data collection sheet for further analysis.

DATA COLLECTION

DATA PROCESSING

Results of the study are presented descriptively in tables and narrative.

RESULT

Total amount of cases in 3 years = 57 cases

DATA PROCESSING

Patients underwent tracheostomy

Variables Mostly Found %

Sex Male 84,2

Age 61-70 yo 33,3

Stage of obstruction Stage III 42,1

Caused of obstruction Laring tumor 59,65

Time of action Elective 56,1

Technique of tracheostomy Open 100

Kind of incision Vertical 98,2

Location of incision Low tracheostomy 100

Complication No complication 91,2

PATIENTS UNDERWENT TRACHEOSTOMY

RESULT

BASED ON AGE

10% 2%

6%

8%

14%

21%

37%

2%

Age

0-10 yo

11-20 yo

21-30 yo

31-40 yo

41-50 yo

51-60 yo

61-70 yo

71-80 yo

BASED ON SEX

84%

16%

Sex

Male Female

RESULTBASED ON CAUSES

59%

7%

7%

5%

5%

3%2%

2%2%

2%

2%

2%

2%

Causes

Laryngeal tumor

Nasopharingeal tumor

Limfoma non hodgkin

Nasopharingeal cancer

Hipopharingeal tumor

Laryngeal cancer

Cyst plica vokalis

Rhabdomyosarkoma of the mouth

PATIENTS UNDERWENT TRACHEOSTOMY

RESULT

BASED ON STAGE BASED ON TIME OF ACTION

Stage

1st stage

2nd stage

3rd stage

4th stage

Time of action

Elective

Emergence

PATIENTS UNDERWENT TRACHEOSTOMY

RESULT

BASED ON TECHNIQUE OF

TRACHEOSTOMYBASED ON KIND OF

INCISION

100%

0%

Technique of tracheostomy

Open

Percutaneus dilatation

98%

2%

Kind of incision

Vertical

Horizontal

PATIENTS UNDERWENT TRACHEOSTOMY

RESULT

BASED ON LOCATION OF

INCISIONBASED ON COMPLICATION

0%

100%

Location of incision

High tracheostomy

low tracheostomy

3% 4%2%

91%

Complication

Emfisema

infeksi

Apnea

SEX

DISCUSSION

M > F(84,2%)

TIME OF ACTION Elective (56,1%)

VARIABLE THIS STUDYOTHER STUDY

M > F (62,3%

Elective (62,7%)

STAGE OF OBSTRUCTION Not mentioned

AGE > 61 y.o 61-70 y.o

3rd stage

CAUSE OF OBSTRUCTION Laryngeal tumor (83,1) Laryngeal tumor (42,1%)

KIND OF INCISION

TECHNIQUE

COMPLICATION

Horizontal (61,4%)

Open procedure (98,8%)

LOCATION OF INCISION Low tracheostomy (38,5%)

Obstruction of canula( 43,4%)

Low tracheostomy (100%)

Vertical ( 98,2%)

Open procedure (100%)

No complication (52%)

DISCUSSION

• Tracheostomy is a surgical procedure that is primarily

done to overcome airway obstruction.

• Results of this study are limited in ENT-HNS Sanglah,

so it does not represent the whole tracheostomy in

Sanglah Hospital because tracheostomy was also

undertaken by the Department of Surgery and

Traumatology Sanglah Hospital.

In this study of 57 patients who underwent tracheostomy several variables related

such as age, sex, causes, degree of obstruction, time measures, technical measures,

types and location of the incisions and complications.

conclusion

This study from January 2012- December 2014 had an age range between 3- 80 years

with an average age of 41.5 years and the largest age group is 61-70 years old.

Characteristics of gender is male 84.2% and female 15.8%. Most causes of tracheostomy

is performed laryngeal tumor by 42.1% with elective action of 56.1% and 43.9%

emergency. In terms of tracheostomy technique, 100% with surgery with incision

location lies low. While the type of incision is done by 98.2% with a vertical incision.

Most of the action is without the complications of tracheostomy that is equal to 91.2%.

In this study of 57 patients who underwent tracheostomy January 2012- December 2014

had an age range between 3- 80 years with an average age of 41.5 years and the largest age

group is 61-70 years old.

conclusion

Characteristics of gender is male 84.2% and female 15.8%. Most causes of tracheostomy

is performed laryngeal tumor by 42.1% with elective action of 56.1% and 43.9% emergency,

100% with surgery with low incision and 98.2% with a vertical incision.

Most of the action is without the complications of tracheostomy that is equal to 91.2%.

With the data on the characteristics of patients who underwent tracheostomy in

ENT-HNS Department in Sanglah Hospital, is expected to support the optimal treatment.

Thank you