Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T08:29:05.009Z Has data issue: false hasContentIssue false
  • English
  • Français

Role of cricothyroid cannulation in head and neck surgery

Published online by Cambridge University Press:  20 February 2008

J C Ryan  and
B McGuire
J C Ryan*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Ninewells Hospital, Dundee, Scotland, UK
B McGuire
Affiliation:
Department of Anaesthesia, Ninewells Hospital, Dundee, Scotland, UK
*
Address for correspondence: Mr J Ryan, Department of Otolaryngology Head and Neck Surgery, Dunedin Hospital, 201 Great King Street Dunedin, New Zealand. Fax: +64 3 4747956 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

This paper outlines our use of cricothyroid cannulation in those patients undergoing head and neck surgery in whom a ‘difficult airway’ is anticipated. Audit results are presented.

Materials and methods:

Prospective data collection for all patients undergoing cricothyroid cannulation for management of head and neck neoplasms, over a two-year period.

Results:

Thirty-nine cricothyroid cannulae were sited in 32 patients. All patients with laryngeal tumours underwent the procedure while awake, prior to the anticipated difficult intubation, and the cannulae were removed within six hours. Most cannulations performed under general anaesthetic were for anticipated ‘dangerous extubations’ in patients with oral cavity tumours, and these cannulae remained in place for 24 hours. Tracheostomy was possibly avoided in six patients. No complications were identified.

Conclusion:

Cricothyroid cannulation can be a simple, safe, reliable technique which is a useful adjunct in the management of patients with a potentially difficult airway.

Keywords

Airway ObstructionTracheostomyHead and Neck Neoplasms
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 10 , October 2008 , pp. 1096 - 1099
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Benumof, JL. Management of the difficult adult airway. Anesthesiology 1991;75:1087–110Google Scholar
2 Benumof, JL, Scheller, MS. The importance of transtracheal jet ventilation in the management of the difficult airway. Anesthesiology 1989;71:769–78Google Scholar
3 Carden, E, Becker, G, Hamood, H. Percutaneous jet ventilation. Ann Otol Rhinol Laryngol 1976;85:652–5CrossRefGoogle ScholarPubMed
4 Miller, J, Lovino, W, Fine, J, Klain, M. High frequency jet ventilation in oral and maxillofacial surgery. J Oral Maxillofac Surg 1982;40:790–3CrossRefGoogle ScholarPubMed
5 Monnier, PH, Ravussin, P, Savary, M, Freeman, J. Percutaneous transtracheal ventilation for laser endoscopic treatment of laryngeal and subglottic lesions. Clin Otol 1988;13:209–17CrossRefGoogle ScholarPubMed
6 Depierraz, B, Ravussin, P, Brossard, E, Monnier, P. Percutaneous transtracheal jet ventilation for pediatric endoscopic laser treatment of laryngeal and subglottic lesions. Can J Anaesth 1994;41:1200–7CrossRefGoogle ScholarPubMed
7 Bourgain, JL, Desruennes, E, Fischler, M, Ravussin, P. Transtracheal high frequency jet ventilation for endoscopic airway surgery: a multicentre study. Br J Anaesth 2001;87:870–5CrossRefGoogle ScholarPubMed
8 Russell, WC, Maguire, AM, Jones, GW. Cricothyroidotomy and transtracheal high frequency jet ventilation for elective laryngeal surgery. An audit of 90 cases. Anaesth Intensive Care 2000;28:62–7CrossRefGoogle ScholarPubMed
9 Gerig, HJ, Schnider, T, Heidegger, T. Prophylactic percutaneous transtracheal catheterisation in the management of patients with anticipated difficult airways: a case series. Anaesthesia 2005;60:801–5CrossRefGoogle ScholarPubMed
10 Standley, TDA, Smith, HL. Emergency tracheal catheterisation for jet ventilation: a role for the ENT surgeon? J Laryngol Otol 2005;119:235–6CrossRefGoogle ScholarPubMed
11 Higgins, KM, Punthakee, X. Meta-analysis comparison of open versus percutaneous tracheostomy. Laryngoscope 2007;117:447–54CrossRefGoogle ScholarPubMed
12 McGill, J, Clinton, JE, Ruiz, E. Cricothyroidotomy in the emergency department. Ann Emerg Med 1982;11:361–4CrossRefGoogle Scholar
13 Smith, BR, Babinski, M, Klain, M, Pfaeffle, H. Percutaneous transtracheal ventilation. Journal of the American College of Emergency Physicians 1976;5:765–70CrossRefGoogle ScholarPubMed