Comparison of Early-Term Results of Tracheotomy Using the Window Technique and Bjork Flap Method.

Hakkı Caner İnan, Büşra Daştan, Betül Ağırgöl, Veyis Şener, Melih Alpay, Hande Özgen
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Abstract

Introduction: Tracheotomy is a common procedure in otorhinolaryngology, aimed at bypassing upper airway. Various surgical techniques exist, including the Bjork flap method and the window technique, each with distinct advantages. The study aimed to compare early complications between these techniques.

Materials and methods: This retrospective study analyzed 164 patients over 18 years old who underwent tracheotomy. Patients were divided based on the technique used: Bjork flap (28.7%) or window (71.3%). Data collected included demographics, comorbidities, and early complications within 7 days postsurgery.

Results: The median age was 68 years, with no significant age difference between the techniques. The Bjork technique involved ligation of the thyroid isthmus in 66.0% of cases versus 20.5% in the window technique (P < .001). Early complications occurred in 69.1% of patients: 12.8% for Bjork and 7.7% for the window technique, with no significant difference (P = .370). Types of complications varied, with cannula displacement, surgical site infection noted in Bjork cases and bleeding, subcutaneous emphysema, false pouch formation, and pneumothorax in window cases.

Conclusion: Although complication rates are similar, subcutaneous emphysema, false pouch formation and pneumothorax have been seen in the window technique. This may indicate that the flap sutured to the skin in the Bjork technique may be useful in preventing the formation of false passage.

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