Thyroid-split tracheostomy: short- and long-term outcomes

OBJECTIVE: Compare long-term outcomes of thyroid-split and standard thyroid-retraction tracheostomy in a large cohort. METHODS: The healthcare database of a university-affiliated hospital was searched for past patients over 18 years of age from all of the hospital’s wards on whom an ear, nose, and throat specialist performed a tracheostomy in the operating room between 2010 and 2020. Clinical data were extracted from the hospital and outpatient medical records. Life-threatening and non-life-threatening intra-operative and early and late post-operative adverse events in patients who underwent split-thyroid tracheostomy were compared with those who underwent standard tracheostomy. RESULTS: There was no significant difference in intra-operative and early post-operative complications, hospitalisation length, or early reoperation and death rates between the 140 (28%) thyroid-split tracheostomy patients and the 354 (72%) standard tracheostomy patients, although the thyroid-split group had more non-decannulated patients and a longer operative time. CONCLUSIONS: Thyroid-split tracheostomy is safe and feasible. Compared to the standard procedure, it provides better exposure and a similar rate of complications, although its de-cannulation success rate is lower.