Outcomes in Morbidly Obese Patients after Skin-Lined Tracheostomy with Cervical Lipectomy

Morbidly obese patients are at an increased risk when undergoing tracheotomy. This is partially attributable to the rate of comorbid conditions in this population, but it is also due to the increased submental and cervical adipose tissue that is common in these patients. Since this patient population is more likely to be dependent on their tracheostomy for a prolonged period, they may be better served by a procedure that removes excess adiposity to create a shallow skin-lined tracheostoma. Medical record review over a 7-year period identified 12 individuals who underwent a skin-lined tracheostomy with cervical lipectomy who had sufficient follow-up allowing for tabulation of complications seen during the immediate and long-term postoperative time periods. The average duration of follow-up was 2.5 years. Complication rates of 0.022 and 0.0013 complications per day per patient were seen in the short- A nd long-term follow-up periods, respectively. The described procedure is more elaborate compared to standard tracheostomy, and thus, it is not surprising that the short-term complication rate is higher than published complication rates for standard tracheostomy. However, the long-term complication rate was lower, verifying that the procedure provides a stable, easy to care for tracheostoma to obese patients who require a tracheostomy.