Karakteristik Penderita Yang Menjalani Trakeostomi di Bagian THT-KL RSUP Sanglah Periode 2012 - 2014.

GOOD AFTERNOON

CHARACTERISTICS OF THE PATIENTS
UNDERWENT TRACHEOSTOMY
IN ENT-HNS DEPARTMENT
IN SANGLAH HOSPITAL
FROM 2012-2014
By: Juniari

Scientific Advisor:
dr. I D.G.Arta Eka Putra, Sp.T.H.T.K.L

INTRODUCTION
TRACHEOSTOMY

operative procedure that creates a surgical airway
in the cervical trachea in patients with inadequate
ventilation or upper respiratory obstruction

location of the incision
the time of action

types of incisions
techniques

H. Adam Malik Hospital in Medan period 2006-2010
 83 patients with tracheostomy action, male 83.1% and female 16.9%.

In ENT-HNS Department
Sanglah Hospital

?

BACKGROUND
ISSUE

What is the characteristic of the patients underwent tracheostomy

in ENT-HNS Department in Sanglah Hospital in 2012-2014?
OBJECTIVE
General: To know the characteristics of patients who underwent tracheostomy in
ENT-HNS Department in Sanglah Hospital in 2012-2014.

Spesific : To know the characteristics of patients who underwent tracheostomy based
on age, sex, cause of obstruction, stadium obstruction, time of action, technique of action,
location of incision, kind of incison

.
BENEFIT

- To provide an overview characteristics of patients
who underwent tracheostomy
- Information for other researchers who will conduct further
research related to the tracheostomy.

LITERATURE REVIEW
ANATOMY & PHYSIOLOGY

Completed tracheotomy:
1. Vocal folds,
2. Thyroid cartilage,
3. Cricoid cartilage
4. Tracheal rings,

5. Balloon cuff.

Literature Review
DEFINITION & INDICATION OF TRACHESTOMY

operative procedure that creates a surgical airway in the cervical trachea in patients with
inadequate ventilation or upper respiratory obstruction

Indication:
1) overcoming upper airway obstruction, 2) support the provision of assistance breath

3) remove secretions from the tracheobronchial, 4)prevent aspiration

Jackson divided the progressive airway obstruction in four stages.

Tracheostomy is contraindicated if conservative measures is still to do

Literature Review
TRACHESTOMY
Can divided into:

Complication:

1.Location of incision

- intraoperative complications

2.Kind of incision

- immediately complications

3. Time of action

- late complications postoperative

4. Technique of tracheostomy

Selection of tracheostomy tube depend on
patient's anatomy and clinical needs, should be rigid but
flexible enough to support adequate respiration and

comfortable for the patient.
Post Tracheostomy Care
Humidification of air, sucking secretions, replacement cannula

CONCEPTUAL FRAMEWORK
Elective
Age
Sex
Cause of obstruction

Stage of
obstruction

Time of
action

TRACHEOSTOMY

Technique

Tracheostomy

Kind of
incision
Complication
Location of
incision

Emergence

Open
Percutaneus
Dilatation
Vertical

Horizontal
High
tracheostomy
Low
tracheostomy

CONCEPTUAL FRAMEWORK

MEDICAL RECORD

Patients underwent tracheostomy:
Age

Sex
Etiology

Stage of obstruction
Time of action

Technique of tracheostomy
Kind of incision

Location of incision
Complication

METHOD
Research Design

Retrospective Design
ENT-HNS Department Sanglah Hospital

Place & Time
January 2012- December 2014 (3 Years Study)

Population

All patients underwent tracheostomy
Sample = Population

Sample

Consecutive Sampling Technique
All patient underwent tracheostomy in ENT-HNS

Inclusion

Departement Sanglah Hospital from
January 2012 until December 2014

Exclusion

Patients with incomplete medical record concerning

in studied variables

METHOD
OPERATIONAL DEFINITION
OF VARIABLE

Tracheostomy, age, sex, cause of obstruction, stage of obstruction, time of action,
technique of tracheostomy, kind of incision, location of action, complication.

DATA COLLECTION
Taken from the medical records of patients who underwent tracheostomy in the

ENT-HNS Department in Sanglah Hospital from Januari 2012 to December 2014.
The results of the examination are recorded in a data collection sheet for further analysis.

DATA PROCESSING
Results of the study are presented descriptively in tables and narrative.

RESULT
Total amount of cases in 3 years = 57 cases

Patients underwent tracheostomy
Variables

Mostly Found

%

Sex

Male

84,2

Age

61-70 yo

33,3

Stage of obstruction

Stage III

42,1

Caused of obstruction

Laring tumor

59,65

Time of action

Elective

56,1

Technique of tracheostomy

Open

100

Kind of incision

Vertical

98,2

Location of incision

Low tracheostomy

100

Complication

No complication

91,2

DATA PROCESSING

RESULT

PATIENTS UNDERWENT TRACHEOSTOMY
BASED ON AGE

Age

37%

BASED ON SEX

Sex

10% 2%
2%
6%
8%

21%
14%

0-10 yo
11-20 yo
21-30 yo
31-40 yo
41-50 yo
51-60 yo
61-70 yo
71-80 yo

Male

Female

16%

84%

BASED ON CAUSES

RESULT

Causes
2%
3%

Laryngeal tumor

2%

2%
2% 2% 2%
2%

Nasopharingeal tumor
Limfoma non hodgkin

5%
5%
7%

Nasopharingeal cancer
59%

7%

Hipopharingeal tumor
Laryngeal cancer
Cyst plica vokalis
Rhabdomyosarkoma of the
mouth

RESULT

PATIENTS UNDERWENT TRACHEOSTOMY
BASED ON STAGE

Stage

BASED ON TIME OF ACTION

Time of action

1st stage
2nd stage
3rd stage
4th stage

Elective
Emergence

RESULT

PATIENTS UNDERWENT TRACHEOSTOMY
BASED ON TECHNIQUE OF

TRACHEOSTOMY

Technique of tracheostomy

BASED ON KIND OF
INCISION

Kind of incision

2%

0%
Open
100%

Percutaneu
s dilatation

98%

Vertical
Horizontal

RESULT

PATIENTS UNDERWENT TRACHEOSTOMY
BASED ON LOCATION OF
BASED ON COMPLICATION

INCISION

Location of incision

0%

100%

High
tracheosto
my
low
tracheosto
my

Complication
3% 4% 2%

Emfisema

infeksi
91%
Apnea

DISCUSSION
VARIABLE

OTHER STUDY

THIS STUDY

SEX

M > F (62,3%

M > F(84,2%)

AGE

> 61 y.o

61-70 y.o

STAGE OF OBSTRUCTION

Not mentioned

3rd stage

CAUSE OF OBSTRUCTION

Laryngeal tumor (83,1)

Laryngeal tumor (42,1%)

TIME OF ACTION

Elective (62,7%)

Elective (56,1%)

LOCATION OF INCISION

Low tracheostomy (38,5%)

Low tracheostomy (100%)

KIND OF INCISION

Horizontal (61,4%)

Vertical ( 98,2%)

TECHNIQUE

Open procedure (98,8%)

Open procedure (100%)

COMPLICATION

Obstruction of canula( 43,4%)

No complication (52%)

DISCUSSION

• Tracheostomy is a surgical procedure that is primarily

done to overcome airway obstruction.
• Results of this study are limited in ENT-HNS Sanglah,
so it does not represent the whole tracheostomy in

Sanglah Hospital because tracheostomy was also
undertaken by the Department of Surgery and
Traumatology Sanglah Hospital.

conclusion
In this study of 57 patients who underwent tracheostomy  several variables related
such as age, sex, causes, degree of obstruction, time measures, technical measures,
types and location of the incisions and complications.

This study from January 2012- December 2014 had an age range between 3- 80 years
with an average age of 41.5 years and the largest age group is 61-70 years old.

Characteristics of gender is male 84.2% and female 15.8%. Most causes of tracheostomy

is performed laryngeal tumor by 42.1% with elective action of 56.1% and 43.9%
emergency. In terms of tracheostomy technique, 100% with surgery with incision

location lies low. While the type of incision is done by 98.2% with a vertical incision.
Most of the action is without the complications of tracheostomy that is equal to 91.2%.

conclusion
In this study of 57 patients who underwent tracheostomy January 2012- December 2014
had an age range between 3- 80 years with an average age of 41.5 years and the largest age
group is 61-70 years old.
Characteristics of gender is male 84.2% and female 15.8%. Most causes of tracheostomy
is performed laryngeal tumor by 42.1% with elective action of 56.1% and 43.9% emergency,
100% with surgery with low incision and 98.2% with a vertical incision.
Most of the action is without the complications of tracheostomy that is equal to 91.2%.

With the data on the characteristics of patients who underwent tracheostomy in

ENT-HNS Department in Sanglah Hospital, is expected to support the optimal treatment.

Thank you