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Airway management during transoral robotic surgery for head and neck cancers: a French GETTEC group survey

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Poissonnet, Valentine | Chabrillac, Emilien | Schultz, Philippe | Morinière, Sylvain | Gorphe, Philippe | Baujat, Bertrand | Garrel, Renaud | Lasne-Cardon, Audrey | Villeneuve, Alexandre | Chambon, Guillaume | Fakhry, Nicolas | Aubry, Karine | Dufour, Xavier | Malard, Olivier | Mastronicola, Romina | Vairel, Benjamin | Gallet, Patrice | Ceruse, Philippe | Jegoux, Franck | Ton Van, Jean | de Bonnecaze, Guillaume | Vergez, Sébastien

Edité par CCSD ; Springer Verlag -

International audience. Purpose: The aim of the survey was to define the indications for preventive tracheostomy in transoral robotic surgery (TORS) for head and neck cancers.Methods: From October 2019 to January 2020, an online questionnaire was e-mailed to French surgical ENT teams with considerable experience of the TORS procedure (Gettec group). A descriptive analysis of the answers was performed.Results: Eighteen French surgical teams answered the questionnaire. For 77.8% of the surgical teams, a past history of radiotherapy with residual edema was an indication for prophylactic tracheostomy, and for 88.9%, > 75 mg of antiplatelet medication or anticoagulation treatment was an indication.Conclusion: Early preventive tracheostomy during TORS can protect airway from uncommon but potentially life-threatening complications, such as transoral hemorrhage or airway edema. We recommend it in high-risk situations, such as a past history of radiotherapy or antiplatelet therapy associated with large resections. Further studies are needed to establish evidence-based recommendations.

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