Trakeostomi Öncesi Boyun Yapılarının Değerlendirilmesi ve Trakeostomi Yönteminin Belirlenmesinde Ultrasonun Etkinliği: Perkütan veya Cerrahi?

GİRİŞ ve AMAÇ: Bu çalışmanın amacı, cerrahi trakeostomi veya PDT kararını vermede ultrasonla boyun muayenesinin etkisini ve PDT'ye bağlı komplikasyon oranlarını değerlendirmektir. YÖNTEM ve GEREÇLER: Bu retrospektif çalışmaya 2015- 2017 yılları arasında 72 hasta dahil edildi. Tüm veriler, Tepecik Eğitim ve Araştırma Hastanesi'ndeki elektronik veri tabanından tarama yapılarak elde edilmiştir. US, krikoid kıkırdakların, trakea halkalarının, tiroidin ve vasküler yapıların konumunu belirlemek için kullanılmıştır. US ile yapılan boyun muayenesinden sonra uygun olmayan olgulara cerrahi trakeostomi kararlaştırıldı. BULGULAR: İki yıl içinde 72 hastaya trakeostomi kararı alındı. Ultrason ile boyun muayenesinden sonra 13 hastaya (% 18) cerrahi trakeostomi uygulandı. Dört hastaya vasküler yapılar, 7 hastaya trakeal halka tespitinde zorluk ve 2 hastaya geniş tiroid dokusu nedeniyle cerrahi trakeostomi kararı alındı. TARTIŞMA ve SONUÇ: Ultrason vasküler yapılar da dahil olmak üzere boyun bölgesinin anatomisi hakkında bilgi sağlar. Boynun ultrason ile muayenesi komplikasyonları azaltmada ve gerçekleştirilmesi zor olabilecek perkütan dilatasyonal trakeostomiyi belirlemede etkilidir.

The Efficacy of Ultrasound to Evaluate The Neck Structures Before Tracheostomy and To Determine The Methods of Tracheostomy: Percutaneous or Surgical?

INTRODUCTION: The aim of this study was to evaluate theinfluence of neck examination with ultrasound on making thedecision of surgical tracheostomy or PDT and complicationrates due to PDT.METHODS: This restrospective study was included 72patients between 2015-2017 years. All the data was obtainedby scanning from the electronic data base in Tepecik Trainingand Research Hospital. US was used to identify the position ofthe cricoid cartilages, trachea rings, thyroid and vascularstructures. After the neck examination with US, surgicaltracheostomy was decided on unsuitable cases.RESULTS: Tracheostomy decision was made to 72 patientswith in 2 years. After the US neck examination, 13 patients(%18) underwent surgical tracheostomy. Surgicaltracheostomy decision was made in 4 patients due to vascularstructures, in 7 patients due to the difficulty of identifyingtracheal rings and in 2 patients due to the thyroid gland.DISCUSSION AND CONCLUSION: US providesinformation regarding the anatomy of the neck region,including vascular structures. US examination of the neck iseffective in reducing complications and determiningpercutaneous dilatational tracheostomy which may be difficultto perform.

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