Avoiding a tracheostomy after mandibulectomy and free flap reconstruction using a staged re-intubation catheter

Patients who undergo head and neck cancer surgery, followed by reconstruction with muscle flaps often have routine tracheostomy to manage the postoperative airway1. This is because in patients with a known difficult intubation, reintubation following extubation is also likely to be difficult2. Also, repeat laryngoscopy would risk damaging intraoral flap sutures. However, the use of a staged re-intubation catheter before extubation as recently reported in your journal by Corso et al may avoid the need for a tracheostomy following major head and neck procedures2.

We would like to report the successful use of a staged re-intubation catheter (Cook Medical, Bloomington, IN, USA) to avoid a tracheostomy in a patient who underwent a mandibulectomy with antebrachial free flap...