Abstract
The tracheal wall is incised between the second and third tracheal ring. The cricoid should be palpated before tracheal incision to determine the correct level at which to enter the trachea. Opening of the trachea with an inferiorly based flap is recommended. To avoid subcutaneous emphysema, pneumothorax, and infection, a tracheotomy wound is never closed tightly around the tube. Setting of threads is useful for stoma opening and tracheostomy tube introduction in children helpful for the stoma opening and tracheostomy tube reinsertion. Percutaneous dilatation tracheostomy (PCDT), when performed by experienced surgerons is safe and easy to perform with a low complication rate. PCDT is suitable only in adult patients without a midline neck mass and if cricoids cartilage can be palpated above the sternal notch. We strongly recommend this technique with good airway control by anesthetists or intensivists, under direct vision with fiberscopy during the procedure.
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© 2009 Springer-Verlag Berlin Heidelberg
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Lawson, G. (2009). Tracheotomy. In: Remacle, M., Eckel, H. (eds) Surgery of Larynx and Trachea. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-79136-2_13
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DOI: https://doi.org/10.1007/978-3-540-79136-2_13
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