{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T02:08:53Z","timestamp":1783908533987,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"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":["The Laryngoscope"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>High volume centers are trialing delayed extubation (DE) as an alternative management strategy to tracheostomy in patients undergoing head and neck reconstruction to bypass the pharyngolaryngeal oedema and ensure unobstructed ventilation. There remains a paucity of synthesized evidence in this area.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>This study represents the largest systematic review on this topic from databases including PubMed, Embase, and Scopus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Review is conducted through JBI's methodology for systematic reviews of effectiveness with findings reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta\u2010analysis statement. A meta\u2010analysis was conducted using the Mantel\u2013Haenszel statistical method with risk ratios and 95% confidence intervals calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For tracheostomy patients, weighted mean hospital and intensive care stay was 13.3 and 1.83\u2009days respectively. For DE, the results were 12.25 and 1.47\u2009days respectively. Meta\u2010analysis for airway complications was statistically significant with a risk ratio of 4.14 (95% CI, 2.67\u20136.40) favoring the DE group. Risk ratio for flap complications was significant at 8.19 (95% CI, 3.41\u201319.65) favoring the DE group. One study reported overall survival and disease\u2010free survival at 88.2% and 68.3% for tracheostomy group respectively, compared to 95.7% and 89.1% in the DE cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tracheostomy can no longer be considered routine and poses risks which should be considered in a shared decision\u2010making model with the patient and assessed within a multidisciplinary setting. This study also highlights the emergence of DE, which can be considered in select patient populations. Further RCTs are required in this area.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70511","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T02:11:51Z","timestamp":1773972711000},"page":"3325-3334","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tracheostomy vs. Delayed Extubation in Head and Neck Reconstruction: A Meta\u2010Analysis"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8364-6103","authenticated-orcid":false,"given":"Sahil","family":"Goel","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery Royal Adelaide Hospital  Adelaide South Australia Australia"},{"name":"Adelaide Medical School, Faculty of Health and Medical Science University of Adelaide  Adelaide South Australia 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