{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:05:17Z","timestamp":1791439517251,"version":"4.3.3"},"reference-count":52,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tracheostomy is frequently performed during flap\u2010based reconstruction for head and neck cancer, but predictive factors and complications are not well established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic review and meta\u2010analysis was conducted per PRISMA guidelines. Studies of adult patients undergoing free or pedicled flap reconstruction were included. Pooled tracheostomy rates, predictors, and complications were analyzed using random\u2010effects models. Heterogeneity was assessed with the I\n                      <jats:sup>2<\/jats:sup>\n                      statistic.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010six studies (27\u2009029 patients) were included. The pooled tracheostomy rate was 54.6%, decreasing to 42.4% when routine tracheostomy studies were excluded. Advanced tumor stage, oropharyngeal site, bilateral neck dissection, prior radiotherapy, and smoking predicted tracheostomy. Flap type was not significantly associated. The overall complication rate was 16.3%, including airway issues (2.6%). No significant change in tracheostomy rates was observed over 30\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tracheostomy use is influenced by tumor, surgical, and patient factors. Selective tracheostomy and validated risk tools may improve outcomes. Further prospective studies are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70102","type":"journal-article","created":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T07:54:57Z","timestamp":1763798097000},"page":"570-582","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Tracheostomy in Flap\u2010Based Head and Neck Cancer Surgery: A Meta\u2010Analysis of Indications and Adverse Outcomes"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5433-5808","authenticated-orcid":false,"given":"Raisa","family":"Chowdhury","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Health Sciences McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khanh Linh","family":"Tran","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Department of Surgery University of British Columbia  Vancouver British Columbia Canada"},{"name":"Division of Otolaryngology \u2013 Head and Neck Surgery Vancouver General Hospital  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naser","family":"Karimi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jhorrit","family":"Kahlon","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons in Ireland  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelius","family":"K\u00fcrten","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology, Department of Surgery University of British Columbia  Vancouver British Columbia Canada"},{"name":"Division of Otolaryngology \u2013 Head and Neck Surgery Vancouver General Hospital  Vancouver British Columbia 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