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Clinical Investigations: AIRWAYS |

Laryngotracheoscopic Findings in Long-term Follow-up After Griggs Tracheostomy*

Ralph Dollner, MD, PhD; Markus Verch, MD; Peter Schweiger, MD; Christina Deluigi; Bernhard Graf, MD, PhD; Frank Wallner, MD
Author and Funding Information

*From the Departments of Otorhinolaryngology, Head and Neck Surgery (Drs. Dollner and Wallner, and Ms. Deluigi), Cardiac Surgery (Drs. Verch and Schweiger), and Anesthesiology (Dr. Graf), University of Heidelberg, Heidelberg, Germany.

Correspondence to: Ralph Dollner, MD, PhD, Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, INF 400, D-69120 Heidelberg, Germany; e-mail: ralph_dollner@med.uni-heidelberg.de



Chest. 2002;122(1):206-212. doi:10.1378/chest.122.1.206
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Objective: Analysis of laryngotracheoscopic findings of the upper airway tract following percutaneous tracheostomy using the technique according to Griggs.

Design: Retrospective cohort study

Patients: Nineteen of 32 long-term surviving patients (mean follow-up duration, 17 months; range, 11 to 23 months) underwent a modified Griggs tracheostomy during their stay in the ICU following cardiothoracic surgery.

Interventions: Nineteen patients gave their informed consent for laryngotracheoscopy to localize and assess the percutaneous dilatational tracheostomy (PDT) puncture site, to evaluate the laryngotracheal morphology, and to quantify tracheal stenosis if present. In addition, specific symptoms of the upper airway tract were evaluated.

Results: At the time of examination, no clinically relevant cases of stenoses were found, although one patient had undergone surgical revision of the PDT for extensive granulation prior to our examination. The endoscopic examination revealed that 12 of 19 patients (63%) had tracheal stenoses > 10%, and 2 patients had tracheal stenoses > 25%. In 7 of 19 patients (32%), the cricoid cartilage was affected by the PDT site. Despite endoscopic guidance during PDT, the location of the puncture site was found to vary greatly.

Conclusion: In contrast to recent reports on the long-term outcome after Griggs PDT, we found tracheal stenoses > 10% in 63% of our patients. The grade of stenosis depended mainly on the puncture site of the PDT. Based on these results, we would emphasize the importance of adequate endoscopic guidance during PDT. Further studies are required in order to clarify the risk of long-term complications arising after PDT using the technique of Griggs.

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