Appropriateness of routine postoperative chest radiography after tracheotomy

Objective: To determine the appropriateness of postoperative chest radiography after adult tracheotomy. Design: Retrospective case series. Setting: Tertiary care academic medical center. Patients: The records of 379 consecutive adult patients who underwent tracheotomy by the Otolaryngology- Head and Neck Surgery Service from January 1992 to December 1996 were available for review and met inclusion criteria. All patients underwent postoperative chest radiography. Main Outcome Measures: Frequency of postoperative tracheotomy-associated complications, most significantly pneumothorax. Results: The patients had no pneumothorax on postoperative chest films. Minor complications, which were found in 7.1% of the patients, included small bleeds, wound infection, and subcutaneous emphysema. Tracheostomy-associated death occurred in 2 patients (0.5%). Conclusions: Routine postoperative chest radiography is unnecessary after adult tracheotomy. Chest radiography may be indicated by clinically suspicious signs or symptoms.