World Journal of Surgery

, Volume 42, Issue 9, pp 2792–2799 | Cite as

Awake Tracheostomy: Indications, Complications and Outcome

  • Doron SagivEmail author
  • Yuval Nachalon
  • Jobran Mansour
  • Eran Glikson
  • Eran E. Alon
  • Arkadi Yakirevitch
  • Gideon Bachar
  • Michael Wolf
  • Adi Primov-Fever
Original Scientific Report



Awake tracheostomy (AT) is aimed at securing the airway of patients with upper airway obstruction when other means are not feasible or have failed. Reports on AT in the literature are scarce. The goal of this study was to review our experience with the indications, complications and outcome of AT.


A retrospective chart review was conducted on all ATs performed between 2010 and 2016 in two university-affiliated, tertiary medical centers. Data on demographics, indications, techniques, urgency and postoperative complications were retrieved from the medical charts.


The 37 of the 1023 recorded tracheostomies (3.62%) that were ATs comprised the study group (mean age of the patients 60.3 years, 32 [86.5%] males). The most common indication was head and neck (HN) malignancy (oncologic group, 70.3%), with the larynx (53.8%) being the most commonly involved site. Patients in the non-oncologic group (n = 11) were significantly younger (P = 0.048) and had a significantly higher prevalence of urgent surgery compared to the oncologic group (P = 0.0009). Major postoperative complications included tube dislodgement (n = 2) and pneumothorax (n = 1) that were managed successfully. One of the two patients with severe hypoxia and arrhythmia that necessitated cardiopulmonary resuscitation died.


Whether the etiology of the AT was related to HN oncological disease or not was the most important clinical factor in our cohort. The non-oncologic group was significantly younger, suffered from more urgent events and tended to have more complications (nonsignificant). ATs had a 97.3% rate of immediate survival, a 5.4% risk of major irreversible complications and a 2.7% risk of mortality.


Compliance with ethical standards

Conflict of interest

There are no financial or personal conflicts of interest to declare.

Ethical standard

The study was approved by the medical centers’ Institutional Review Boards.


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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  1. 1.Department of Otolaryngology and Head and Neck Surgery, Sheba Medical CenterTel HashomerRamat GanIsrael
  2. 2.Department of Otolaryngology and Head and Neck SurgeryRabin Medical CenterPetah-TikvaIsrael
  3. 3.Sackler Faculty of MedicineTel-Aviv UniversityTel AvivIsrael

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