Studies of non-endoscopically guided PDT have shown the incidence of pneumothorax, pneumomediastinum, and paratracheal tube insertion to be up to 12%,2–3
compared to studies of bronchoscopically guided PDT, which have not shown these complications.4
Our audit confirmed the low rate of complications and, similarly to the study by Datta et al,1
questioned the value of the routine postprocedure chest radiograph. In 221 procedures, the postprocedure chest radiograph served only to review the angulation of one tracheostomy. However, given the low rate of complications, together with the potentially life-threatening nature of potential complications, we are currently continuing this study prospectively and have gathered data on a further 80 patients to date. We agree with Datta et al1
that more data are required before we can agree that after the performance of uncomplicated, endoscopically guided PDTs in adult patients there is no need to perform a routine postprocedure chest radiograph.