Efficacy of overnight intubation in oral oncological surgeries: A retrospective study

Aim: In the postoperative period of maxillofacial oncological operations, tracheostomy is the most commonly used method for securing the airway. These untoward complications made practitioners chose alternative modalities like submental intubation, but literature support on alternatives to tracheostomy for oral oncologic cases is limited. The aim of this observational study is to ascertain whether the use of overnight intubation is a safer and cost-effective practice and if it can be considered an alternative to tracheostomy. Materials and methods: Thirty patients, 23 males and 7 females in the age group of 34–80 years who underwent treatment for head and neck cancer with major intraoral resection and a unilateral or bilateral neck dissection were included in the study. The following variables were recorded: age, sex, site of a tumor, type of neck dissection, use of mandibulotomy/ mandibulectomy, type of reconstruction, duration of stay in ICU, mean hospital stay and Mallampati classification. Postoperative complications, associated with the airway, if any, were recorded simultaneously. Results: None of the 30 patients required re-intubation nor did they develop any respiratory distress post-extubation. Conclusion: To conclude, mandatory unquestioned use of tracheostomy in every head and neck oncological case should be avoided and its use should be limited to the situations where overnight intubation is not feasible, prolonged duration of postoperative intubation is required or it is anticipated that return visits will be made by the patient. Clinical significance: The clinical significance of this study is to show that the mortality and morbidity associated with a tracheostomy can be avoided. Overnight intubation is the modality to replace tracheostomy and can be considered as the gold standard.