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<p>Elective tracheostomy is commonly performed after major oral cavity resection (OCR) to secure the airway. However, tracheostomy tube decannulation (TTD) practices vary widely, with limited head and neck cancer (HNC)-specific guidelines. This study surveyed global TTD practices to identify safe and effective approaches.&#xa0;A 16-item online questionnaire was distributed to head and neck surgeons and speech-language pathologists (SLPs), yielding 252 responses. Data on TTD timing, methods, monitoring, and guideline preferences were analyzed using descriptive statistics and chi-square tests.&#xa0;Respondents (87% India, 13% international) included qualified head and neck surgeons (74%), otolaryngologists (11%), and SLPs (7%). Most (93%) supported dedicated TTD guidelines, but only 47% used institutional protocols. Decannulation trials began 3–7 days post-OCR for 68%, with occlusion/spigotting preferred (71%) over endoscopy (28%). Post-TTD monitoring occurred in general wards (44%) or postoperative wards (24%), with 53% using pulse oximetry and 85% keeping spare tracheostomy equipment bedside. Practice variability was significant, with differences by country and experience level.&#xa0;Heterogeneous TTD practices highlight the need for evidence-based, HNC-specific protocols to optimize safety and timing. This first-of-its-kind survey identifies consensus areas and gaps in current practice.</p><p><i>Level of evidence</i>: Level 4 (Crosssectional survey).</p>

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Elective Tracheostomy Decannulation Practices in Head and Neck Cancer Patients Undergoing Major Oral Cavity Resection: A Global Survey

  • 期刊论文

  • 发表日期：

    2026年7月8日

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  • Arvind Krishnamurthy,
  • Mahalakshmi Shetty,
  • Vilasini Raman,
  • K. Gurukeerthi,
  • V. Manikandan,
  • V. Venktesh,
  • Pranav Mohan

摘要

Elective tracheostomy is commonly performed after major oral cavity resection (OCR) to secure the airway. However, tracheostomy tube decannulation (TTD) practices vary widely, with limited head and neck cancer (HNC)-specific guidelines. This study surveyed global TTD practices to identify safe and effective approaches. A 16-item online questionnaire was distributed to head and neck surgeons and speech-language pathologists (SLPs), yielding 252 responses. Data on TTD timing, methods, monitoring, and guideline preferences were analyzed using descriptive statistics and chi-square tests. Respondents (87% India, 13% international) included qualified head and neck surgeons (74%), otolaryngologists (11%), and SLPs (7%). Most (93%) supported dedicated TTD guidelines, but only 47% used institutional protocols. Decannulation trials began 3–7 days post-OCR for 68%, with occlusion/spigotting preferred (71%) over endoscopy (28%). Post-TTD monitoring occurred in general wards (44%) or postoperative wards (24%), with 53% using pulse oximetry and 85% keeping spare tracheostomy equipment bedside. Practice variability was significant, with differences by country and experience level. Heterogeneous TTD practices highlight the need for evidence-based, HNC-specific protocols to optimize safety and timing. This first-of-its-kind survey identifies consensus areas and gaps in current practice.

Level of evidence: Level 4 (Crosssectional survey).