Indication of Tracheotomy in the ENT department of the Gabriel Toure University Hospital

Introduction: Tracheostomy is the opening of the cervical trachea followed by the placement of a cannula. It is intended to provide a short circuit of the upper airway. The aim of this study is to review the indications for tracheostomy. Materials and methods: This is a retrospective study of 43 tracheotomized patients treated in the otorhinolaryngology department of Gabriel University Hospital. Toure de Bamako for a period of 6 years from January 2017 to August 2024. Results: The work involved 27 men (62.8%) and 16 women (37.2%), with a sex ratio of 1.69. The mean age of the patients was 38.295 years with extremes of 2.67 and 77 years. Laryngeal dyspnoea (n= 28) and dysphonia (n=26) were the main symptoms of consultation. Most tracheostomies were performed as an emergency procedure in 79.1% of cases (n=34), with scheduled tracheostomies performed in 20.9% of cases (n=9). The conditions requiring tracheostomy were dominated by malignant tumours of the larynx and pharynx (26.4%), followed by post-thyroidectomy recurrent paralysis (7.9%), trauma to the larynx (10.5%) and penetrating neck wounds (4.7%). Laryngeal papillomatosis was the main indication in children (4 children). The technique used was classical surgical tracheotomy, often performed under general anaesthesia (53.5%) and under local anaesthesia in emergency cases (46.5%). The skin incision was transverse in most cases (n=38) (88.4%) and vertical in 11.6% (n=5). Complications related to tracheostomy were diverse, generally benign, and occurred in 1% of cases. Mortality occurred in 3 of our patients whose cannulas were still in place, a rate of 8.1% (n=3). Conclusion: Whatever the indication, tracheostomy is a life-saving procedure whose usefulness and effectiveness are certain. Mastery of the technique, rigorous monitoring and postoperative care are the main conditions for minimising the risk of complications.