Timing of tracheostomy in major head and neck surgery: preoperative or intraoperative?

The management of tracheostomy in head and neck oncology requires a personalized, evidence-based approach. Key recommendations include prioritizing elective over emergent procedures, mastering the awake technique for compromised airways, using scoring systems to guide selective tracheostomy in oral cancers, and adhering to strict oncologic principles to prevent tumor seeding.