Displaying publications 1 - 20 of 52 in total

  1. Lim PV, Raman R
    Otolaryngol Head Neck Surg, 2001 Jan;124(1):56-7.
    PMID: 11228454
    Matched MeSH terms: Tracheostomy/instrumentation*
  2. Teah KM, Tsen SSY, Fong KK, Yeap TB
    BMJ Case Rep, 2021 Jun 08;14(6).
    PMID: 34103307 DOI: 10.1136/bcr-2021-243559
    Tracheostomy is an aerosol-generating procedure and performing it in patients with COVID-19 requiring mechanical ventilation raises significant concerns of infection risk to healthcare workers. We herein report a case of tracheostomy in a critically ill patient with severe COVID-19 acute respiratory distress syndrome. This article depicts the use of personal protective equipment, highlighting the common challenges it presents and ways to address them.
    Matched MeSH terms: Tracheostomy
  3. Razak I, Hari K, Syakirah Z, Saiful M, Shahrul H
    Med J Malaysia, 2023 Jan;78(1):35-38.
    PMID: 36715189
    INTRODUCTION: The COVID-19 pandemic is unprecedented. Amongst those who contracted COVID-19, a number required intubation and prolonged ventilation. This increased the number of ventilated patients in the hospital and increased the requirement for tracheostomy of severe COVID-19 patients. Our objective is to study the outcome of patients with COVID-19 who underwent tracheostomy.

    MATERIALS AND METHODS: This study is a novel retrospective study in a tertiary centre in Malaysia. Case notes of COVID- 19 patients who underwent tracheostomy in Hospital Ampang were collected using the electronic Hospital Information System. Data were analysed using the SPSS system.

    RESULTS: From a total of 30 patients, 15 patients survived. All patients underwent either open or percutaneous tracheostomy. The median age is 53 (range: 28-69) with a significant p-value of 0.02. Amongst comorbidities, it was noted that diabetes mellitus was significant with a p-value of 0.014. The median time from the onset of COVID-19 to tracheostomy is 30 days. The median duration of intensive care unit (ICU) stay is 30.5 days, with the median duration of hospital length of stay of 44 days (p = 0.009 and <0.001, respectively). No complications that contributed to patient death were found. Survivors had a median of 29.5 days from tracheostomy to oxygen liberation.

    CONCLUSION: Tracheostomy in COVID-19 patients that requires prolonged ventilation is unavoidable. It is a safe procedure and mortality is not related to the procedure. Mortality is primarily associated with COVID-19.

    Matched MeSH terms: Tracheostomy/methods
  4. Alhady SMA, Bowler DP, Reid HA, Scott LT
    Br Med J, 1960;1:540-545.
    Tetanus may be mild, moderate, severe, or inevitably fatal. Our clinical experience suggests it may be classified as severe (or, maybe, inevitably fatal) when a tetanic spasm stops respiration. Ten patients with severe tetanus were treated by the total paralysis regime (T.P.R.), consisting of tracheostomy, curarization, and intermittent positiveor positive/negative-pressure respiration. Two of the patients were saved by T.P.R. and therefore only limited effectiveness can be claimed for the regime. In inevitably fatal cases survival can be prolonged by T.P.R. so that further effects of tetanus toxin emerge. Of these, the most important appears to be direct damage to the myocardium.
    Matched MeSH terms: Tracheostomy
  5. Ming CC, Ghani SA
    J Laryngol Otol, 1989 Mar;103(3):335-6.
    PMID: 2703781
    A fractured tracheostomy tube is a rare complication; cases have been reported in the past, usually associated with prolonged usage in patients with chronic airway obstruction. We present here a fracture occurring in a new tube, and also describe a method for retrieving the tube from the tracheobronchial tree.
    Matched MeSH terms: Tracheostomy/instrumentation*
  6. Ng CS, Foong SK, Loong SP, Ong CA, Hashim ND
    J Int Adv Otol, 2021 Jul;17(4):301-305.
    PMID: 34309549 DOI: 10.5152/iao.2021.0078
    BACKGROUND: Postoperative or post-traumatic canal restenosis in patients with external auditory canal (EAC) stenosis is a troublesome complication faced by many ear surgeons following canalplasty or meatoplasty. Many ear prostheses and surgical methods have been introduced to prevent the occurrence of such complication. Our aim in this study is to explore the feasibility of using modified non-fenestrated uncuffed tracheostomy tubes (TT) as postoperative stents after ear canal surgery.

    METHODS: Canalplasty or meatoplasty was performed under general anesthesia via the posterior auricular transcanal approach. The EAC diameter and length were measured and a non-fenestrated uncuffed TT of suitable size was fitted into the ear canal. The TT was then modified during fitting, to fit onto the concha. Patients were advised on the importance of compliance. The adequacy of the size of the EAC after the surgery was assessed during follow-ups.

    RESULTS: A total of 3 patients (4 ears) were included in our study. Various sizes of TTs were fitted into their EAC following canalplasty or meatoplasty. All of them showed excellent postoperative outcome on follow up 2 years after the surgery, with no evidence of postoperative EAC stenosis.

    CONCLUSION: Modified TT stent after canalplasty or meatoplasty is proposed as an excellent alternative in preventing restenosis of EAC in centers with limited resources.

    Matched MeSH terms: Tracheostomy*
  7. Arunathan R, Ariffin AHZ, Khor KG, Tan SN
    Pediatric investigation, 2019 Sep;3(3):191-193.
    PMID: 32851317 DOI: 10.1002/ped4.12148
    Introduction: Congenital tracheal stenosis (CTS) is a serious and rare condition. In most cases, CTS is associated with cardiopulmonary abnormalities; however, isolated CTS is present in 10%-30% of patients. The severity of the disorder is dependent on the symptoms, which correlate with the CTS classification.

    Case presentation: We discuss our findings in an infant who presented with severe respiratory compromise where incidental intra-operative findings revealed CTS with no cardiopulmonary abnormalities. Because of a lack of resources in the emergency department, we created a tracheostoma and inserted an endotracheal tube.

    Conclusion: The main aim in treating CTS is to secure the airway and provide sufficient oxygen.

    Matched MeSH terms: Tracheostomy
  8. Kumar R, Zenian MS, Maeng TY, Fadzil F, Mohd Azli AN
    Int J Environ Res Public Health, 2022 Nov 26;19(23).
    PMID: 36497820 DOI: 10.3390/ijerph192315746
    Early tracheostomy is recommended for patients with severe traumatic brain injury or stroke. Tracheostomy in the same setting as emergency decompressive craniectomy, on the other hand, has never been investigated. Our goal was to compare the outcomes related to the duration of mechanical ventilation in patients who had immediate (IT) vs. early (ET) tracheostomy following an emergency decompressive craniectomy in a Neurosurgical centre in Sabah, Malaysia. We reviewed 135 patients who underwent emergency decompressive craniectomy for traumatic brain injury (TBI) and stroke patients between January 2013 and January 2018 in this retrospective cohort study. The cohort included 49 patients who received immediate tracheostomy (IT), while the control group included 86 patients who received a tracheostomy within 7 days of decompressive surgery (ET). The duration of mechanical ventilation, length of stay (LOS) in the critical-care unit, and intravenous sedation were significantly shorter in the IT group compared to the ET group, according to the study. There was no significant difference between the two groups in the incidence of ventilator-associated pneumonia (VAP), tracheostomy-related complications, or 30-day mortality rate. In conclusion, compared to early tracheostomy, immediate tracheostomy in the same setting as emergency decompressive craniectomy is associated with a shorter duration of mechanical ventilation and LOS in critical-care units with acceptable morbidity and mortality rates. This practise could be used in busy centres with limited resources, such as those where mechanical ventilators, critical-care unit beds, or OT wait times are an issue.
    Matched MeSH terms: Tracheostomy
  9. Mahmud N, Abdul Latif H, Mohd Zaki F, Goh BS
    BMJ Case Rep, 2021 Apr 02;14(4).
    PMID: 33811090 DOI: 10.1136/bcr-2020-236888
    Pfeiffer syndrome is a rare inherited craniofacial disorder. Upper airway obstruction is common among patients with Pfeiffer syndrome due to craniosynostosis. They may also present with lower respiratory tract obstruction due to a rare congenital airway malformation called tracheal cartilaginous sleeve (TCS). We report the case of a patient with Pfeiffer syndrome who presented with recurrent bronchopneumonia, discovered incidentally to have TCS via direct visualisation during tracheostomy. Relevant literature for this rare clinical condition are reviewed and discussed. Clinicians should be aware of TCS when encountering patients with craniosynostosis who present with recurrent lower respiratory tract infections. Careful and meticulous investigations should be performed to look for TCS, especially in patients with craniosynostosis.
    Matched MeSH terms: Tracheostomy
  10. Primuharsa Putra SH, Wong CY, Hazim MY, Megat Shiraz MA, Goh BS
    Med J Malaysia, 2006 Jun;61(2):209-13.
    PMID: 16898313
    Indication for pediatric tracheostomy has changed. Upper airway obstruction secondary to infectious disorders is no longer the commonest indication. The aim of this study was to establish data on indications, outcome and complications of pediatric tracheostomy. A retrospective analysis of pediatric tracheostomies carried out between March 2002 to March 2004 was done. Eighteen patients were identified. The commonest indication was prolonged ventilation (94.5%) followed by pulmonary toilet (5.5%). None was performed for upper airway obstruction. Postoperative complications were encountered in six patients (33.3%), the commonest being accidental decannulation notably in children less than six years of age. Twelve patients (66.6%) were successfully decannulated. The mortality rate was 16.6%. All death were non tracheostomy related. The commonest indication for tracheostomy was prolonged ventilation and tracheostomy in children is relatively safe despite complications.
    Matched MeSH terms: Tracheostomy/trends*; Tracheostomy/statistics & numerical data
  11. Tan CC, Lee HS, Balan S
    Med J Malaysia, 2004 Dec;59(5):591-7.
    PMID: 15889560
    All percutaneous tracheostomies performed in the general intensive care unit (ICU), Hospital Sultanah Aminah, Johor Bahru, Malaysia, from July 1999 to June 2002 were studied. The tracheostomies were performed as an elective bedside technique in the ICU. A total of 352 percutaneous tracheostomies were performed. Eighty-eight percent of the tracheostomies were completed within 15 minutes. The most common complication was bleeding which occurred in 52 patients (14.7%). The rest of the complications encountered were:- transient hypoxia twelve (3.4%), inability/ difficulty to insert tracheostomy tube eight (2.3%), false passage four (1.1%), transient hypotension two (0.6%), pneumothorax two (0.6%), peristomal infection two (0.6%), subcutaneous emphysema one (0.3%), cuff rupture one (0.3%), oesophageal cannulation one (0.3%), and granuloma formation one (0.3%). Conversion to conventional tracheostomies were performed on 7 patients (2%). There was one unfortunate death related to percutaneous tracheostomy. In conclusion, percutaneous dilational tracheostomy can be used safely to manage the airway of critically ill patients.
    Matched MeSH terms: Tracheostomy/adverse effects*; Tracheostomy/methods*
  12. Rao AS, Mansor L, Inbasegaran K
    Med J Malaysia, 2003 Jun;58(2):213-7.
    PMID: 14569741 MyJurnal
    During a 6-month period from October 2000 to March 2001, we analysed the indications, methods, waiting period and complications following a tracheostomy at the General Intensive Care Unit (GIGU) of Hospital Kuala Lumpur. There were 49 tracheostomies performed during this period. Thirty of them were performed in the GICU using the percutaneous dilatational method while 19 were performed electively in the Operating Theatre (OT) by the ear, nose and throat (ENT) surgeons. The main indications for a tracheostomy were prolonged mechanical ventilation and airway protection for patients with a poor Glasgow Coma Scale. The average waiting time for a tracheostomy after a decision was made to perform one was 1.34 +/- 0.72 days for a percutaneous tracheostomy and 3.72 +/- 2.52 days for a surgical tracheostomy. This difference was statistically significant (p < 0.001). There was excessive bleeding in 3 patients in the percutaneous tracheostomy group and 1 patient in the surgical tracheostomy group. Percutaneous tracheostomy is now the main method of tracheostomy at the GICU in Hospital Kuala Lumpur. Haemorrhage is the most significant complication of this procedure. However the overall complication rate is comparable with that of a surgical tracheostomy.
    Matched MeSH terms: Tracheostomy/adverse effects*; Tracheostomy/methods*
  13. Ghaffar ZA, Chong SE, Tan KL, Appalanaido GK, Musa MY, Hussin HB, et al.
    J Contemp Brachytherapy, 2018 Dec;10(6):573-576.
    PMID: 30662482 DOI: 10.5114/jcb.2018.79856
    The practice of brachytherapy in unresectable tongue carcinoma is gaining popularity. However, this procedure poses specific anesthetic challenges, particularly challenges of airway sharing and a higher rate of difficult airway. We report a 74-year-old chronic smoker, chronic alcoholic with history of stroke, who had undergone brachytherapy for tongue carcinoma. Apart from a huge tongue tumor, he had an epiglottic mass but refused elective tracheostomy. This had led to a few critical states throughout the process of treatment, including a metabolic crisis due to thiamine deficiency and difficult airway crisis. To our best knowledge, there have been no reported case on a patient with vocal cord mass undergoing tongue brachytherapy. We hope sharing of this experience may aid the management of similar patients in future.
    Matched MeSH terms: Tracheostomy
  14. Mohamad I, Jihan WS, Mohamad H, Abdullah B
    Malays J Med Sci, 2008 Jan;15(1):42-3.
    PMID: 22589614
    Bilateral abductor vocal cord palsy is comparatively a rare vocal cord lesion, especially in a patient with no history of neck mass, previous surgery or trauma. Many patients are not stridulous. A patient presenting with stridor may need emergency airway management before the other treatment is commenced. We report a case of bilateral abductor palsy which required an emergency tracheostomy and subsequently a laser posterior cordectomy.
    Matched MeSH terms: Tracheostomy
  15. Nasir MSNM, Ishak MN, Abd Wahid FH, Asif JA, Mohamad I
    Medeni Med J, 2019;34(4):400-403.
    PMID: 32821468 DOI: 10.5222/MMJ.2019.44977
    Oral cyst is uncommon in the neonatal period. Depending on the size and site of occurrence, its symptoms may vary. If not diagnosed and managed expeditiously, these oral cysts may cause significant and potentially fatal morbidity and mortality. We report a successfully managed case of oral cyst in neonate that presented with huge tongue at birth and complaints of impending airway obstruction. She was referred for tracheostomy as intubation was impossible. We attempted needle aspiration and the airway successfully relieved without the need for tracheostomy.
    Matched MeSH terms: Tracheostomy
  16. Loi, H.D.K., Wong, K.T., Choo, K.E.
    An eight-year-old Chinese girl presented with a slowly progressive generalized muscle weakness and wasting, complicated by respiratory failure. She had many hospital admissions requiring ventilator support. Eventually tracheostomy tube was inserted. Initial investigations failed to elicit a diagnosis but a muscle biopsy and histological study confirmed the diagnosis of juvenile acid maltase deficiency.
    Matched MeSH terms: Tracheostomy
  17. Periasamy, Chentilnathan, Irfan Mohamad, Khairul Bariah Johan, Nik Fariza Husna Nik Hassan
    Tracheostomy is a life saving surgical procedure performed to maintain upper airway ventilation. The
    indications include providing relief of upper airway obstruction, to replace endotracheal intubation in patients needing prolonged assisted ventilation, protection of tracheobronchial tree and facilitates tracheobronchial toilet.More importantly, post operative tracheostomy care is very crucial for the success of the treatment and avoiding complications. We report a rare case of an obligate parasite which had infested the tracheal stoma due to poorhygiene.
    Matched MeSH terms: Tracheostomy
  18. Roselinda Abdul Rahman, Irfan Mohamad, Rohaizam Jaafar
    Managing a patient with a huge intraoral mass is always challenging. Manipulation or even a simple biopsy of the mass may lead to hemorrhage and further compromise the airway. An examination under anesthesia is not without risk. The method of securing the airway itself may become an issue if the mass is fully occupying the airway before intubation. Usually a tracheostomy is indicated. We share a gentleman presented with a huge intraoral mass occupying the oropharynx, which initially necessitates tracheostomy. We utilized the ultrasonic scalpel-assisted instrument to biopsy by debulking the tumour, thus avoiding the tracheostomy while waiting for the definitive treatment.
    Matched MeSH terms: Tracheostomy
  19. Irfan Mohamad, Yusri Musa, M.
    Tracheocutaneous fistula (TCF) is a known complication of tracheostomy. It can cause problems such as saliva leak, predispose to infection from external skin into respiratory tract and cosmetically not acceptable. Treatment of the underlying infection is paramount important. Persistence of tract after sufficient duration of observation period should be surgically treated. Cases reported in the literature are mainly regarding paediatric TCF and the procedures are usually done under general anesthesia. We describe a case of surgical treatment of an adult TCF which was done under local anaesthesia.
    Matched MeSH terms: Tracheostomy
  20. Shashinder S, Tang IP, Kuljit S, Muthu K, Gopala KG, Jalaludin MA
    Med J Malaysia, 2008 Aug;63(3):254-5.
    PMID: 19248703 MyJurnal
    A synthetic tracheostomy tube [non-metallic type] fracturing within three days of insertion is very rare but it could lead to serious complications such as acute asphyxia or sudden death. We report three such cases at our centre. Recommendations are made to closely observe patients on tracheostomy tube in the first seven days post-insertion of the tube.
    Matched MeSH terms: Tracheostomy/instrumentation*
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