Safety and practicability of percutaneous translaryngeal tracheotomy (Fantoni technique) in surgery of maxillofacial and oropharyngeal tumours – Own results and review of the literature

SummaryBackgroundThe study examines the suitability of the Fantoni method of translaryngeal tracheotomy (TLT) for airway management after surgery due to oropharyngeal and maxillofacial tumours.Patients and methodsDuring a 4-year period, 156 translaryngeal pull-through tracheotomies were performed in 145 patients. This method is the only puncture tracheotomy technique that involves a dilatation process from inside the trachea to the outside through the skin and differs from other established puncture methods regarding practicability and frequency of complications.ResultsThe mean puncture time (from puncture of the trachea to correct tube placement) was 10.1 ± 4.8 min. With an oxygen supply of FiO2 = 1.0 the oxygen saturation prior to TLT was 98.4 ± 1.29%, and the lowest median saturation value during the TLT procedure was 96.7 ± 3.9%. No serious complications such as bleeding, loss of airway, pneumothorax or death were observed. Complications occurring during the TLT procedure were exclusively technical and at no time were they life-threatening.ConclusionsTLT is a technique with few complications and a straightforward procedure for those familiar with the method. It has some advantages compared with other puncture techniques which appear to commend TLT in terms of safety for the patient.