{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T19:10:16Z","timestamp":1775243416928,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,10,3]],"date-time":"2018-10-03T00:00:00Z","timestamp":1538524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005788","name":"Medical University of Vienna","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives\/Hypothesis<\/jats:title>\n                    <jats:p>Surgical tracheostomy (ST) with creation of an inferiorly based U\u2010shaped tracheal flap, known as the Bj\u00f6rk flap, is the most commonly performed. The purpose of this study was to evaluate whether outcome was different in patients who underwent low ST with retraction and preservation of the thyroid isthmus compared to those who underwent high ST with ligation of the thyroid isthmus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 1,143 patients who underwent ST with creation of a Bj\u00f6rk flap between 2008 and 2015. Different outcome parameters, including complications, decannulation, inpatient mortality, and surgical characteristics, such as length of surgery and height of tracheal incision, were assessed comparing low and high ST.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Complications occurred in 7.7% of patients, of which persistent stoma (4.1%) and hemorrhages (2.7%) were the most common. Low tracheostomy with retraction and preservation of thyroid isthmus was done in 31.4% of cases. Complications did not significantly differ between low and high tracheostomies (8.0% vs. 7.0%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.468). Moreover, decannulation rate and inpatient mortality were also not significantly different in low compared to high tracheostomies (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.816 and\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.152, respectively). However, low tracheostomies were associated with significantly shorter operation times (33.0\u2009\u00b1\u20090.8\u2009min vs. 38.7\u2009\u00b1\u20090.5\u2009min,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and lower tracheal incisions for creation of a Bj\u00f6rk flap (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001) compared to high tracheostomies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Low tracheostomies are as safe as high tracheostomies regarding complications. Due to the fact that low tracheostomies are associated with shorter operation times and lower tracheal incisions, we recommend performong low tracheostomies whenever feasible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      4\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 128:2783\u20132789, 2018\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.27310","type":"journal-article","created":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T15:13:30Z","timestamp":1538752410000},"page":"2783-2789","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Preserving the thyroidal isthmus during low tracheostomy with creation of a\n                    <scp>B<\/scp>\n                    j\u00f6rk flap"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1161-4871","authenticated-orcid":false,"given":"Stefan","family":"Janik","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Kliman","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Hacker","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Medical University of Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boban M.","family":"Erovic","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Medical University of Vienna Vienna Austria"},{"name":"Institute for Head and Neck Diseases Evangelical Hospital Vienna Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00020840-200312000-00012"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000145232.46143.40"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.161.5.9902018"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000251585.31778.c9"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-014-0544-7"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc4887"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otot.2007.05.003"},{"key":"e_1_2_6_9_1","first-page":"79","article-title":"A technique of tracheostomy","volume":"92","author":"Kinley CE","year":"1965","journal-title":"Can Med Assoc J"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2000.105714"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-3019(84)90050-8"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21907"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.123.1.151"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.90.2.269"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459989411100410"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23887"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000231802.83152.59"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(81)90413-7"},{"key":"e_1_2_6_19_1","doi-asserted-by":"crossref","first-page":"542","DOI":"10.4187\/respcare.05500542","article-title":"Late complications of tracheostomy","volume":"50","author":"Epstein SK","year":"2005","journal-title":"Respir Care"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6109(16)45586-6"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199203000-00002"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(95)70279-2"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(95)00464-V"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)63438-8"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.27310","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.27310","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T18:35:27Z","timestamp":1775241327000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.27310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,3]]},"references-count":23,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1002\/lary.27310"],"URL":"https:\/\/doi.org\/10.1002\/lary.27310","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,3]]},"assertion":[{"value":"2018-01-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-05-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}